Cryptosporidiosis after CD34-selected autologous peripheral blood stem cell transplantation (PBSCT). Treatment with paromomycin, azithromycin and recombinant human interleukin-2.
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.
Nachbaur
D
D
Department Internal Medicine, University Hospital, Innsbruck, Austria.
Kropshofer
G
G
Feichtinger
H
H
Allerberger
F
F
Niederwieser
D
D
D000328:Adult; D018952:Antigens, CD34 / Q000378:metabolism; D017963:Azithromycin / Q000008:administration & dosage*; D003457:Cryptosporidiosis / Q000188:drug therapy / Q000209:etiology* / Q000628:therapy*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006412:Hematopoietic Stem Cells / Q000276:immunology; D006689:Hodgkin Disease / Q000628:therapy; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D007376:Interleukin-2 / Q000008:administration & dosage*; D008174:Lung Diseases, Parasitic / Q000188:drug therapy / Q000209:etiology / Q000628:therapy; D016131:Lymphocyte Subsets / Q000276:immunology; D016403:Lymphoma, Large B-Cell, Diffuse / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000188:drug therapy / Q000209:etiology* / Q000628:therapy*; D010303:Paromomycin / Q000008:administration & dosage*; D011994:Recombinant Proteins / Q000008:administration & dosage; D014182:Transplantation, Autologous
D018952:Antigens, CD34; D007376:Interleukin-2; D011994:Recombinant Proteins; D010303:Paromomycin; D017963:Azithromycin