Résumé
BACKGROUND: Although haploidentical transplantation has become a clinical reality for acute myeloid leukemia (AML) patients lacking a HLA compatible donor due to several encouraging reports, it is still considered as one of an experimental treatment modalities. METHODS: Eleven patients received stem cell transplantation from family donors having mismatched HLA haplotypes. For patients who were planned for 2 or 3 major antigens mismatch transplantation, their conditioning regimens included total-body irradiation (TBI), intravenous busulfan, antithymocyte globulin, and fludarabine in 6 patients and non-TBI containing regimen in 2 patients. For 3 patients with 1 major antigen mismatch sibling donor, we used 3 different regimens according to the patients' condition. The median number of infused CD34+ cells were 15.4x10(6)/kg (range, 8~21.2). RESULTS: Ten patients who were followed up for at least median 4 months (range, 17 days-15 months) showed stable engraftment. Patients who received haploidentical transplantation in first or second complete remission (CR), all showed continuous CR within our study period and showed no acute graft-versus-host disease or transplant-related mortality during 100 day posttransplant. Three of 5 patients who were in relapse or refractory state finally died in relapse. Two of 3 patients who received the full haplotype mismatch transplantation in CR died after 4 months posttransplant due to critical infections associated with delayed immune recovery. CONCLUSION: Our experience suggests that haploidentical transplantation is at least, in part, feasible or desperate treatment for patients with high-risk AML in CR. We need further stable plan to enhance the immune recovery for these patients as soon as possible.
Sujets)
Humains , Sérum antilymphocyte , Busulfan , Maladie du greffon contre l'hôte , Haplotypes , Leucémie aigüe myéloïde , Mortalité , Récidive , Fratrie , Transplantation de cellules souches , Donneurs de tissusRésumé
Scrub typhus is a acute febrile disease. Most patients were occurred from October to Nouember. The chief complaints were fever and chill, headache, cough, myalgia, pharyngitis and lymphadenopathy. Some patients with scrub typhus manifested with acute renal failure, meningoencephalitis, or hepatitis, but scrub typhus was rarely manifested with severe respiratory disease such as adult respiratory distress syndrome(ABDS). We report a case of scrub typhus manifested with ARDS. The patient was treated with doxycycline and recovered successfully.
Sujets)
Adulte , Humains , Atteinte rénale aigüe , Doxycycline , Fièvre , Céphalées primitives , Hépatite , Maladies lymphatiques , Méningoencéphalite , Myalgie , Pharyngite , Fièvre fluviale du JaponRésumé
A diabetic 73-year-old man had admitted and examined gastrofiberoscopy due to dyspagia and weight loss of 6 kg during two months. He was confirmed diagnosis of esophageal squamous cell carcinoma. During the esophagography, we found the dye spillage into pericardial space from the esophagus with air collection. A following chest roentgenogram revealed a typical pneumopericardium with pericardial air filling. Although intensive care was done, he expired 4 days later. We report a case of typical pnemopericardium caused secondary to esophageal cancer.