EMR without BM involvement after allogeneic HSCT is extremely rare, especially in children; only a few cases have been reported. A two-yr-old boy was diagnosed with AML (M4) and underwent allogeneic HSCT in first complete remission with BM from HLA-matched unrelated donor without GVHD. Four yr later, he had a BM relapse and after induction and consolidation chemotherapy, he received a second HSCT from an unrelated donor using peripheral blood stem cells. His second post-transplant course was complicated by extensive chronic GVHD involving the skin, oral cavity, and lungs, which was treated with tacrolimus and corticosteroid. Two yr later, he noticed a mild swelling in the right cheek area. The BM showed a complete remission marrow and a soft tissue biopsy was compatible with granulocytic sarcoma. PET-CT showed multifocal bone involvements. He received chemotherapy, and the chloromas decreased in size. We report a case of diffuse EMR of AML without BM involvement after a second allogeneic HSCT.
Background and ObjectivesZZChitin is a recognition element for tissue infiltration by innate cells implicated in allergy and asthma. Chitinases are characterized by the ability to cleave chitin. YKL-40, the chitinase-like protein, was increased during Th2-type inflammation in an exaggerated manner in tissues of patients with asthma. However, the relationship of YKL-40 level to allergic rhinitis has not been evaluated. Hence, we evaluated the relationship between the YKL-40 level in the blood and nasal lavage fluid and allergic inflammation in nasal cavity. We also evaluated the nature of association between several important factors (eosinophil count and total IgE) in the blood and nasal lavage fluid of allergic rhinitis patients. Subjects and MethodZZThe concentrations of the YKL-40 levels in the blood and nasal lavage fluid were compared between allergic rhinitis patients and healthy controls. We evaluated the YKL-40 levels in the blood and nasal lavage fluid and also evaluated symptom severity, eosinophil count, and total IgE. ResultsZZThe blood YKL-40 level was not significantly increased in allergic rhinitis (49 pg/ mL) than in control (44 pg/mL)(p>0.05). The YKL-40 levels in the nasal lavage fluid was not significantly increased in allergic rhinitis (1568 pg/mL) than in control (1248 pg/mL)(p>0.05). The YKL-40 levels in blood and nasal lavage fluid were not associated with important factors such as symptom severity, eosinophil count, and total IgE in allergic rhinitis patients. ConclusionZZThere is no association between the YKL-40 level in the blood and nasal lavage fluid, allergic inflammation in nasal cavity.
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