1. [Anti-MDA5 antibody-positive rapidly progressive interstitial lung disease after allogeneic hematopoietic cell transplantation successfully treated with triple immunosuppressive therapy].
- Author
-
Nakamura Y, Kawamura S, Matsumi S, Matsumoto K, Tanaka S, Ishikawa T, Matsuoka A, Meno T, Kawamura M, Takeshita J, Yoshino N, Yoshimura K, Misaki Y, Gomyo A, Okada Y, Tamaki M, Kusuda M, Akahoshi Y, Kameda K, Wada H, Kimura SI, Nakasone H, Kako S, Date H, and Kanda Y
- Subjects
- Male, Female, Humans, Adult, Cyclophosphamide therapeutic use, Cyclosporine therapeutic use, Prednisolone therapeutic use, Immunosuppression Therapy, Immunosuppressive Agents therapeutic use, Hematopoietic Stem Cell Transplantation adverse effects, Graft vs Host Disease drug therapy, Graft vs Host Disease etiology, Lung Diseases, Interstitial drug therapy, Lung Diseases, Interstitial etiology
- Abstract
A 34-year-old man with KMT2A-MLLT1 acute myeloid leukemia in first complete remission underwent allogeneic peripheral blood stem cell transplantation from his HLA-matched sister after conditioning with busulfan/cyclophosphamide. He did not have severe graft-versus-host disease, but he developed interstitial pneumonia six months after transplantation when his oral cyclosporine A (CsA) dose was reduced to 10 mg/day. He was given prednisolone (PSL), which temporarily improved his respiratory condition, but he quickly deteriorated when PSL was reduced. Anti-MDA5 antibody was found to be positive after additional testing, and a three-drug combination of intravenous cyclophosphamide+PSL+CsA was initiated for anti-MDA5 antibody positive rapidly progressive interstitial lung disease, which was effective for interstitial pneumonia. He received a successful living-donor lung transplant from his younger brother and sister. We present a case of rapidly progressive anti-MDA5 antibody positive interstitial lung disease in which the patient's respiratory condition improved after triple therapy and subsequent living-donor lung transplantation.
- Published
- 2023
- Full Text
- View/download PDF