[Systemic microsporidiosis and toxoplasmosis in a patient with T prolymphocytic leukemia]. / Microsporidiose et toxoplasmose disséminées chez une patiente présentant une leucémie prolymphocytaire T.

We report a case of microsporidiosis in a 72-year-old woman presenting with prolymphocytic leukemia. The underlying conditions 7 months after leukemia was diagnosed were pancytopenia and immunosuppression due to alemtuzumab and pentostatin. The patient's status had worsened and she presented with dysuria. Urine cultures for bacteria were repeatedly negative. She was first empirically treated with broad-spectrum antibiotics. Three months later, urinary symptoms were persisting. Her blood lymphocyte count was 90/microl. Urine examination was positive for microsporidia using modified trichrome staining and Uvitex 2B fluorescence. Microsporidia were also detected in stools. The patient was cured by albendazole. This was consistent with an infection due to Encephalitozoon sp. Concurrently, disseminated toxoplasmosis was diagnosed. Toxoplasma gondii was detected in bone marrow, broncho-alveolar lavage and cerebrospinal fluid. She was successfully treated with sulfadiazine-pyrimethamine. Four cases of microsporidiosis in myeloid leukemic patients have been already described. The present case in a patient with lymphoid leukemia is the first to be reported.

Successful treatment of chronic adult T-cell leukemia with ubenimex.

A 38-year-old Japanese man had suffered from trichophyton infection for several years. The white blood cell count was 20,300/mm3, including 54% abnormal lymphocytes with irregularly convoluted nuclei. Adult T-cell leukemia (ATL) was diagnosed based on proliferation of CD4-positive lymphocytes, positive anti-HTLV-I antibody and monoclonal integration of proviral DNA. By 30 mg/day of ubenimex (Bestatin), the abnormal lymphocytes positive for CD4 in the peripheral blood were gradually reduced. Complete remission was maintained for 9 months without any antineoplastic agents. Ubenimex may have suppressed the growth of ATL cells in this patient. Accordingly, ubenimex may prove useful for treating some patients with chronic-type ATL.