· 2012-03-19 · & e'9 • 1 & ;;;-

24
H. T.

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Page 1:  · 2012-03-19 · & E'9 • 1 & ;;;-

H. T.

Page 2:  · 2012-03-19 · & E'9 • 1 & ;;;-

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

Page 14:  · 2012-03-19 · & E'9 • 1 & ;;;-

(<30 )

• 50-80%

(Cyclophosphamide, MTX etc)

(

)

IPA)

( 90%)

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(30-100 )

PCP:

CMV :BMT 70%30-40%

(ES)

(IPS)

Page 16:  · 2012-03-19 · & E'9 • 1 & ;;;-

(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%

Page 18:  · 2012-03-19 · & E'9 • 1 & ;;;-

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

Page 22:  · 2012-03-19 · & E'9 • 1 & ;;;-

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