Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A patient with hypoplastic acute myelogenous leukemia (AML) who achieved remission with granulocyte colony-stimulating factor (G-CSF) alone is reported. The 59-year-old male patient received antibiotics and G-CSF but not any antileukemic drugs because of ongoing pneumonia. After 2-week administration of G-CSF, he achieved complete remission and his pneumonia improved. Since leukemia relapsed after 3 months, he received G-CSF again for 5 weeks, but failed to be in remission this time. He underwent antileukemic chemotherapy and achieved second remission. When he suffered from a second relapse after 7 months, intensive chemotherapy was commenced but was stopped on the 2nd day since his general condition became very poor due to septicemia. He began to receive G-CSF again and achieved third complete remission after 3 weeks. In vitro studies showed that G-CSF did not stimulate proliferation of the patient's blast cells although they expressed G-CSF receptor on their surface. Moreover, G-CSF induced differentiation of the blast cells into segmented neutrophils in vitro. According to the literature, in all of the 12 patients with AML who were reported to achieve remission by G-CSF the course was complicated by infection, and 7 of the patients were diagnosed as hypoplastic acute leukemia. It is suggested that not G-CSF alone but G-CSF with infection could induce remission, which might be related to a differentiation effect of G-CSF in this case. G-CSF is not only safe but also useful for remission induction therapy in hypoplastic acute leukemia.
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PMID:Remission induction by granulocyte colony-stimulating factor in hypoplastic acute myelogenous leukemia complicated by infection. A case report and review of the literature. 964 2

Kostmann syndrome (KS) is an inherited hematological disorder characterized by an absolute neutrophil count (ANC) <0.2 x 109/L and life-threatening bacterial infections. Granulocyte-colony stimulating factor (G-CSF) makes it possible to reach an ANC of 1.0 x 109/L and consequently to reduce significantly the occurrence of severe infections. Absence of response to G-CSF, G-CSF receptor mutation, and leukemic transformation are absolute indications to perform hematopoietic stem cell transplantation (HSCT). Pulmonary mycosis does not represent an absolute contraindication to bone marrow transplantation (BMT), although a relapse rate of 30-50% has been reported, despite adequate medical and surgical treatment. Mycotic pneumonia recurrence shows a mortality rate above 80%, especially in the presence of persisting immunosuppression. We report on a KS patient with long-lasting fungal pneumonia who developed myelodysplasia and subsequent acute myeliod leukemia (AML) conversion resistant to antiblastic therapy. Despite surgical excision and secondary prophylaxis, recurrence of the pulmonary lesion occurred prior to the unrelated HSCT. In spite of these poor prognostic characteristics, outcome was uneventful and the patient is alive and well in continuous complete remission with no signs of fungal infection.
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PMID:Uneventful outcome of unrelated hematopoietic stem cell transplantation in a patient with leukemic transformation of Kostmann syndrome and long-lasting invasive pulmonary mycosis. 1269 70

This article describes the first case of acute myeloid leukemia (AML) in a healthy donor at 14 months after granulocyte colony-stimulating factor (G-CSF)-primed peripheral blood stem cell (PBSC) harvest. In September 2001, a healthy 61-year-old female was given G-CSF prior to PBSC harvest for her brother with multiple myeloma. In spite of successful engraftment, the recipient died from a disease relapse. In November 2002, the donor, admitted with high fever and leukocytosis with 98.5% blastoid cells, was diagnosed as having AML (M1). Her leukemia cells were positive for CD13, CD33, and G-CSF receptor without chromosomal abnormality and responded to G-CSF in vitro. During chemotherapy, she died of progressive pneumonia. If our case is truly the first, the incidence of leukemia in donors may not be higher than that of naturally occurring leukemia. However, efforts towards an international long-term study, or at least to report every case similar to ours, would be required to be conclusive.
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PMID:Acute myelogenous leukemia in a donor after granulocyte colony-stimulating factor-primed peripheral blood stem cell harvest. 1471 37