· 2012-03-19 · & e'9 • 1 & ;;;-

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