Abstract
We report two cases of cryptosporidiosis after CD34-selected PBSCT for lymphoma. While the first patient died of pulmonary cryptosporidiosis, treatment with paromomycin, azithromycin and subcutaneous low-dose rhIL-2 to improve numerical and functional T lymphocyte defects completely eliminated infection in the second patient. We conclude, that the removal of mature T lymphocytes by positive selection of CD34+ cells bears the risk of a delayed immune reconstitution resulting in an increased incidence of severe and sometimes fatal opportunistic infections. IL-2 might be useful in this situation by accelerating immune reconstitution and reducing the danger of opportunistic infections.
Publication types
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Case Reports
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Research Support, Non-U.S. Gov't
MeSH terms
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Adult
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Antigens, CD34 / metabolism
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Azithromycin / administration & dosage*
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Cryptosporidiosis / drug therapy
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Cryptosporidiosis / etiology*
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Cryptosporidiosis / therapy*
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Female
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Hematopoietic Stem Cell Transplantation / adverse effects*
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Hematopoietic Stem Cells / immunology
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Hodgkin Disease / therapy
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Humans
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Immunosuppression Therapy / adverse effects
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Interleukin-2 / administration & dosage*
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Lung Diseases, Parasitic / drug therapy
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Lung Diseases, Parasitic / etiology
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Lung Diseases, Parasitic / therapy
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Lymphocyte Subsets / immunology
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Lymphoma, Large B-Cell, Diffuse / therapy
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Male
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Middle Aged
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Opportunistic Infections / drug therapy
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Opportunistic Infections / etiology*
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Opportunistic Infections / therapy*
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Paromomycin / administration & dosage*
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Recombinant Proteins / administration & dosage
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Transplantation, Autologous
Substances
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Antigens, CD34
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Interleukin-2
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Recombinant Proteins
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Paromomycin
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Azithromycin