No abstract

Graft-versus-host disease (GVHD) is a major cause of morbidity and mortality after bone marrow transplantation. Well-documented manifestations of GVHD include dermatologic, gastrointestinal, hepatic, pulmonary, musculoskeletal, and hematologic manifestations and sicca syndrome. To date, the heart has only rarely been reported to be a target of GVHD. We report a series of patients who developed bradycardia, coronary artery disease, or cardiomyolysis in association with acute or chronic GVHD. The severity of these manifestations ranged from asymptomatic to fatal. The bradycardias were responsive to increased immunosuppression. Although they are uncommon, it is important to recognize these cardiac manifestations, because they may reflect GVHD activity and may be reversible by increasing immunosuppression.

We report the clinical course of a patient who developed a Rhizopus infection of his right lung and pleural cavity, 11 months after receiving a T-cell-depleted, haploidentical donor peripheral blood stem cell transplant. Thoracotomy was performed to remove the pulmonary lesion, but residual disease in the pleural cavity was noted. Treatment with amphotericin B was complicated by the development of severe renal dysfunction, necessitating alternative antifungal therapy. Treatment was initiated with the investigational triazole posaconazole. Despite concurrent treatment with corticosteroids for graft-versus-host disease (GVHD), the patient had a complete response and remains well 4 years later.

No abstract

No abstract