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