Oral Kaposi sarcoma following cord blood transplantation.
Oral Kaposi sarcoma following cord blood transplantation.
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DOI：
10.1002/jha2.387
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发表时间：
2022-05
期刊：
影响因子：
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通讯作者：
Iida, Hiroatsu
中科院分区：
文献类型：
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作者：
Imahashi, Nobuhiko;Arakawa, Mikiko;Iwakoshi, Akari;Mori, Mikiko;Nagai, Hirokazu;Iida, Hiroatsu
一名50岁的男性在接受人类免疫缺陷病毒（HIV）感染的抗逆转录病毒治疗时患上了急性髓性白血病。经过三个疗程的化疗，他在第一次完全缓解时接受了脐带血移植（CBT）。患者在CBT后出现轻度皮肤急性移植物抗宿主病。此外，他在CBT治疗后1个月出现组织性肺炎，对类固醇治疗有反应，但在类固醇逐渐减少治疗期间反复复发。因此，他一直在接受长期免疫抑制治疗。CBT后13个月，口腔硬腭出现蓝红色升高病变（图1A）。从腭病变处获得的活检样本证实了卡波西肉瘤（KS）的诊断。他的HIV病毒载量检测不出来，也没有白血病复发的迹象。为改善免疫抑制状况，减轻免疫抑制治疗。这导致CD4+计数从0.26× 109/L增加到0.68× 109/L， KS回归（图1B， CBT后18个月）。然而，患者在CBT后18个月死于心脏和肾衰竭。尽管罕见，但当造血干细胞移植受者出现蓝红色或紫色病变时，KS应被视为鉴别诊断。
A 50-year-old man developed acute myeloid leukemia while receiving antiretroviral therapy for human immunodeficiency virus (HIV) infection. Following three courses of chemotherapy, he received cord blood transplantation (CBT) in the first complete remission. The patient developed mild skin acute graft-versus-host disease after CBT. In addition, he developed organizing pneumonia 1 month after CBT, which responded to steroid therapy, but repeatedly relapsed during steroid tapering. Thus, he had been receiving prolonged immunosuppressive therapy. Thirteen months after CBT, bluish-red elevated lesions developed on the hard palate of the oral cavity (Figure 1A). Biopsy samples obtained from the palate lesions confirmed the diagnosis of Kaposi sarcoma (KS). His HIV viral load was undetectable, and there were no signs of leukemia relapse. To improve the immunosuppression status, immunosuppressive therapy was attenuated. This led to the increase in CD4+ count from 0.26× 109/L to 0.68× 109/L and regression of the KS (Figure 1B, 18 months after CBT). However, the patient succumbed to heart and kidney failure 18 months after CBT. Despite its rarity, KS should be considered as a differential diagnosis when hematopoietic stem cell transplantation recipients develop bluish-red or purple lesions.