Invasive aspergillosis in two patients with acute lymphoblastic leukaemia in complete remission

• Published in: Postgraduate medical journal Vol. 69; no. 811; pp. 405 - 408
• Main Authors: Turner, M. L., Russell, L., Milne, L. J., Parker, A. C.
• Format: Journal Article
• Language: English
• Published: London The Fellowship of Postgraduate Medicine 01.05.1993; BMJ; Oxford University Press; BMJ Group
• Subjects: Adult; Aspergillosis - complications; Aspergillosis - pathology; Aspergillus fumigatus - isolation & purification; Biological and medical sciences; Female; Hematologic and hematopoietic diseases; Humans; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Male; Medical sciences; Middle Aged; Precursor Cell Lymphoblastic Leukemia-Lymphoma - complications; Precursor Cell Lymphoblastic Leukemia-Lymphoma - pathology; Risk Factors; Time Factors; Tomography, X-Ray Computed; Infection; Case study; Human; Mycosis; Acute; Lymphoproliferative syndrome; Aspergillosis; Complication; Remission; Malignant hemopathy; Acute lymphocytic leukemia
• ISSN: 0032-5473; 1469-0756
• DOI: 10.1136/pgmj.69.811.405

Invasive aspergillosis is a disease of the immunosuppressed patient. We describe two patients with acute lymphoblastic leukaemia who attained complete remission, with partial or complete bone marrow recovery, but who went on to develop fatal invasive aspergillosis contemporaneous with recovery of neutrophil counts. Quantitative recovery of peripheral blood neutrophil counts does not guarantee control of Aspergillus infection, perhaps due to functional neutrophil deficiencies post-chemotherapy, and specific defensive strategies adopted by the organism itself.