Successful cord blood transplantation for myelodysplastic syndrome complicated by Mycobacterium kansasii pneumonia

Abstract

Non-tuberculous mycobacterial (NTM) disease is a rare cause of neutropenic fever in patients with hematological malignancies. There are few studies on the optimal management for such patients with NTM. We report a case of myelodysplastic syndrome (MDS) treated by umbilical cord blood transplantation (CBT) after Mycobacterium kansasii (M kansasii) pneumonia. A 38-year-old man diagnosed with MDS developed severe pneumonia during induction chemotherapy. Repeated sputum culture uncovered mycobacterium infection. Then, by the polymerase chain reaction of the bronchial lavage fluid, M kansasii infection was proven. After 140 days of anti-NTM therapy, CBT was successfully carried out and the patient recovered without recurrence of NTM infection. This case provides valuable evidence that hematopoietic stem cell transplantation is feasible after a reliable diagnosis and continuous anti-NTM therapy. K E Y W O R D S cord blood transplantation, Mycobacterium kansasii, myelodysplastic syndrome, nontuberculous mycobacterial disease How to cite this article: Yamada A, Akahane D, Katagiri S, et al. Successful cord blood transplantation for myelodysplastic syndrome complicated by Mycobacterium kansasii pneumonia.

Disseminated nontuberculous mycobacterial infection prior to hematopoietic stem cell transplantation: A case of successful treatment

“…In the two previous reports of NTM pneumonia, anti-NTM medications were administered for 70 and 150 days prior to HSCT with improved lung lesions. 4,5 Notably, the resolution of the lung consolidation was not observed with pretransplant treatment but was observed after engraftment, which appeared to parallel the recovery of host immunity. This suggests that the duration of NTM treatment during the pre-HSCT period should be individualized to avoid delaying the timing of HSCT once the infection is under control.…”

“…3 Despite accumulating evidence from studies conducted in the post-HSCT setting, only two case reports have described patients who underwent HSCT complicated with NTM infection prior to the transplantation. 4,5 Specifically, there are no published reports of disseminated NTM infection before HSCT, which has been associated with a poor outcome and a mortality rate of 60.3% in immunocompromised populations. 6 Herein, we present a case of successful cord blood transplantation (CBT) with concurrent antimycobacterial treatment to address pulmonary and bloodstream Mycobacterium kansasii infection during the peri-HSCT period.…”