A Case of Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia with Aspergillus Brain Abscess and Invasive Pulmonary Aspergillosis Successfully Treated with Voriconazole Followed by Cord Blood Transplantation

摘要

A 59-year-old female was diagnosed as pulmonary aspergillosis (IPA) while remission induction therapy for Philadelphia chromosome-positive acute lymphoblastic leukemia. Liposomal amphotericin B improved the fungal serodiagnostic markers, however, the IPA worsened. She also developed an Aspergillus brain abscess, which, while being undetectable on CT, was detected as multiple nodular lesions by MRI. A definitive diagnosis was made by polymerase chain reaction (PCR) of brain biopsy specimens. Voriconazole (VRCZ) was effective, and cord blood transplantation was performed. She has received VRCZ for a long time. There are no relapse of either the IPA or the Aspergillus brain abscess.