· 2012-03-19 · & E'9 • 1 & ;;;-
Transcript of · 2012-03-19 · & E'9 • 1 & ;;;-
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H. T.
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20
myeloid sarcoma
chemotherapy(DNR/AraC) CR
rBMT( )
4
1st relapse(AML)
chemotherapy(DNR/AraC) CR
,allo PBSCT( )
2nd relapse
chemotherapy(BHAC/ACR) CR
uBMT
day29
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day43 CT
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day82 CT
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day89
day98
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day98 CT
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day171 99mTc-DTPA
aerosol
99mTc-
MAAT1/2 (min.)
28 43
41 40
Bronchiolitis
obliterans
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day158 CT
, day286
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•
• (HSCT)
(autologous transplantation)
(allogeneic transplantation)
HLA
(GVHD)
(GVL )
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(HSCT)
(TBI)
• (BMT)
• (PBSCT)
• (CBT)
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•( BMT) 40-60%
25.4%
• 54.8% 39.7%
•GVHD
•
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(HSCT)
• (<30 )
• (30-100 )
• (100 -1 )
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• BMT 2-4
•
• 4-5
6-
12
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(<30 )
• 50-80%
(Cyclophosphamide, MTX etc)
•
(
)
IPA)
( 90%)
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(30-100 )
•
•
PCP:
CMV :BMT 70%30-40%
•
(ES)
(IPS)
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(100 -1 )
•
•
LONIPCs(Late-onset noninfectious pulmonary
complications)
• 3
• GVHD
BO
OP,NSIP,LIP,DAD
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Bronchiolitis obliterans(BO)
• allogeneic transplantation 10%
• 61%
•
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Bronchiolitis obliterans(BO)• air trapping CT
• HRCT( ) mosaic pattern
•
• CT
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Bronchiolitis obliterans(BO)
• Bronchiolitis obliterans syndrome(BOS)
CT airflow
obstruction ( 1
20% ) BOS
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Bronchiolitis obliterans(BO)
•hot spot
•
••matched defect
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Organizing pneumonia(OP)
• HSCT 10%
• GVHD OP
(
)
• GGA>consolidation
•
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Organizing pneumonia(OP)
AML(M0)
10
1st CR HLA BMT
BMT 120
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Organizing pneumonia(OP)
BMT day120 day 169 day 233
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• BMT GVHD BO
• 3
•
GVHD