title: [Elderly chronic lymphocytic leukemia combined with invasive aspergillosis infection in one case].
abstract: OBJECTIVE
  This study was aimed to investigate the morphological, immunophenotype, cytogenetic characteristics, clinical and therapy features in one elderly patient with chronic lymphocytic leukemia (CLL) combined with invasive aspergillose infection(IAI).
  
  
  METHODS
  The morphological features of bone marrow cells from patient were observed by light microscope, the immunophenotype were detected by flow cytometry, the cytogenetic characteristics were assayed by conventional chromosomal analysis and fluorescence in situ hybridization (FISH).
  
  
  RESULTS
  at onset of disease, the patient was diagnosed as B-CLL, Rai stage is II. He was treated with a course of RF(fludarabine 50 mg×5, rituximab 600 mg×5) chemotherapy, and achived complete remission (CR) lasting for five years, then the patient was treated with multiple courses of chemotherapy and maintained at a steady state of disease. After the last chemotherapy, this patient developed a fever, his temperature fluctuated at 37.2-38.7°C, the lung CT showed the presence of massive shadow, repeated 1-3-β-D-glucan test was positive,and he was considered as invasive aspergillosis infection, voriconazole was intravenously injected him for 2 months, his lung CT showed better efficacy. However, the leukemia continued progress, his hemogram was extremely low, invasive aspergillosis infection relapsed,voriconazole treatment was poor effect,ultimately this patient died of the rapid progress of leukemia and multiple organ invasive aspergillosis. Autopsy showed chronic lymphocytic leukemia with multiple metastases and multiple organ invasive aspergillosis.
  
  
  CONCLUSIONS
  invasive aspergillosis is a serious complication for CLL patients,once occurs, the prognosis is poor,so early diagnosis and prophylactic antifungal therapy may reduce fungal infection complication.
authors: Department of Geriatric Hematology, Chinese PLA General Hospital, Beijing 100853, China.
authors: Bao-Ling
authors: BL
authors: Li
authors: Department of Geriatric Hematology, Chinese PLA General Hospital, Beijing 100853, China.
authors: Su-Xia
authors: SX
authors: Li
authors: Department of Burns and Plastic Surgery, The First Affiliated Hospital of Chinese PLA General Hospital, Beijing 100048, China.
authors: Tong-Min
authors: TM
authors: Wang
authors: Department of Geriatric Hematology, Chinese PLA General Hospital, Beijing 100853, China. E-mail: bjzhl202_cn@ sina.com.
authors: Hong-Li
authors: HL
authors: Zhu
authors: Department of Geriatric Hematology, Chinese PLA General Hospital, Beijing 100853, China; Department of Hematology, The First Affiliated Hospital of Chinese PLA General Hospital, Beijing 100048, China.
authors: Hai-Tao
authors: HT
authors: Wang
authors: Department of Pathology, Chinese PLA General Hospital, Beijing 100853, China.
authors: Jie
authors: J
authors: Li
authors: Department of Geriatric Hematology, Chinese PLA General Hospital, Beijing 100853, China.
authors: Yang
authors: Y
authors: Liu
authors: Department of Geriatric Hematology, Chinese PLA General Hospital, Beijing 100853, China.
authors: Bing
authors: B
authors: Zhai
mesh_terms: D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived; D000935:Antifungal Agents; D000971:Antineoplastic Combined Chemotherapy Protocols; D001228:Aspergillosis; D005434:Flow Cytometry; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D015451:Leukemia, Lymphocytic, Chronic, B-Cell; D008297:Male; D012074:Remission Induction; D000069283:Rituximab; D014740:Vidarabine / Q000031:analogs & derivatives
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000935:Antifungal Agents; D000069283:Rituximab; D014740:Vidarabine; C024352:fludarabine