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Detection of Invasive Pulmonary Aspergillosis in Haematological Malignancy Patients by using Lateral-flow Technology
Published on: March 22, 2012
[Elderly chronic lymphocytic leukemia combined with invasive aspergillosis infection in one case]
Bao-Ling Li1, Su-Xia Li1, Tong-Min Wang2
1Department of Geriatric Hematology, Chinese PLA General Hospital, Beijing 100853, China.
Insights
Invasive aspergillosis is a serious complication for chronic lymphocytic leukemia (CLL) patients, often leading to a poor prognosis. Early diagnosis and prophylactic antifungal therapy are crucial to reduce fungal infection complications.
Area of Science:
- Hematology
- Mycology
- Oncology
Background:
- Chronic lymphocytic leukemia (CLL) is a common hematologic malignancy.
- Invasive aspergillosis (IA) is a life-threatening fungal infection.
- CLL patients are immunocompromised, increasing their susceptibility to IA.
Observation:
- A case study of an elderly patient with B-CLL, Rai stage II.
- The patient achieved initial complete remission after fludarabine and rituximab chemotherapy.
- IA developed after chemotherapy, complicated by leukemia progression and poor treatment response.
Findings:
- The patient experienced recurrent IA, ultimately succumbing to leukemia progression and disseminated fungal infection.
- Autopsy confirmed CLL with metastases and multiple organ IA.
- Morphological, immunophenotype, and cytogenetic analyses were performed.
Implications:
- IA poses a significant threat to CLL patients, associated with a grave prognosis.
- Prompt diagnosis and preemptive antifungal strategies are vital for managing IA in CLL.
- This case highlights the critical need for vigilance against opportunistic infections in leukemia patients.
Objective:
This study was aimed to investigate the morphological, immunophenotype, cytogenetic characteristics, clinical and therapy features in one elderly patient with chronic lymphocytic leukemia (CLL) combined with invasive aspergillose infection(IAI).
Methods:
The morphological features of bone marrow cells from patient were observed by light microscope, the immunophenotype were detected by flow cytometry, the cytogenetic characteristics were assayed by conventional chromosomal analysis and fluorescence in situ hybridization (FISH).
Results:
at onset of disease, the patient was diagnosed as B-CLL, Rai stage is II. He was treated with a course of RF(fludarabine 50 mg×5, rituximab 600 mg×5) chemotherapy, and achived complete remission (CR) lasting for five years, then the patient was treated with multiple courses of chemotherapy and maintained at a steady state of disease. After the last chemotherapy, this patient developed a fever, his temperature fluctuated at 37.2-38.7°C, the lung CT showed the presence of massive shadow, repeated 1-3-β-D-glucan test was positive,and he was considered as invasive aspergillosis infection, voriconazole was intravenously injected him for 2 months, his lung CT showed better efficacy. However, the leukemia continued progress, his hemogram was extremely low, invasive aspergillosis infection relapsed,voriconazole treatment was poor effect,ultimately this patient died of the rapid progress of leukemia and multiple organ invasive aspergillosis. Autopsy showed chronic lymphocytic leukemia with multiple metastases and multiple organ invasive aspergillosis.
Conclusion:
invasive aspergillosis is a serious complication for CLL patients,once occurs, the prognosis is poor,so early diagnosis and prophylactic antifungal therapy may reduce fungal infection complication.
