在治疗急性淋巴细胞白血病期间治疗侵袭性真菌病的治疗方法
Ibrahim Alharbi1, Amro Nassif2, Yasser B Hennawi3
1Department of Pediatrics, Umm Al-Qura University, Makkah, Saudi Arabia.
Journal of medical cases
|June 12, 2025
概括
患有前体B细胞急性淋巴细胞白血病 (pre-B-ALL) 的儿童的侵入性阿斯伯吉洛症需要积极的抗真菌治疗. 组合治疗沃里康纳和卡斯波芬金,随后是沃里康纳,使得化疗恢复和患者康复.
科学领域:
- 儿科瘤学 儿科瘤学
- 传染性疾病 传染性疾病
- 血液学 血液学 血液学
背景情况:
- 侵入性真菌病 (IFD) 在急性白血病 (AL) 患者中具有显著的死亡风险.
- 由于复发的可能性,IFDs可以干扰化疗的完成.
- 阿斯珀吉洛症是儿科急性淋巴细胞白血病 (ALL) 中的一个关键IFD.
研究的目的:
- 在患有前体B细胞急性淋巴细胞白血病 (pre-B-ALL) 的儿童中报告两例侵入性阿斯伯吉洛斯病例.
- 描述在接受化疗的儿科B-ALL前期患者中IFD的管理和结果.
主要方法:
- 两名儿科B-ALL前患者的病例报告经历了发烧性中性质疏松症.
- 诊断工作包括CT扫描和血清生物标志物 (银曼南,BDG).
- 治疗涉及组合抗真菌疗法 (卡斯波金和沃里可纳),随后是单剂疗法 (沃里可纳).
主要成果:
- 两位患者都出现了严重的发烧性中性质和确诊的侵袭性阿斯伯吉洛症,肺,肝脏和脏都受到影响.
- 组合抗真菌疗法导致临床康复,发烧和中性质衰竭的缓解,并改善了成像发现.
- 在68周的中断后,化疗成功地恢复了.
结论:
- 积极的组合抗真菌疗法在治疗儿科B-ALL前的侵袭性阿斯伯吉洛症方面是有效的.
- 建议对ALL患者进行抗真菌预防.
- 停止化疗的决定应根据真菌感染的严重程度和患者的病情进行个性化决定.
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