ALLOGENEIC BMT IN A PATIENT WITH CML AND PRIOR DISSEMINATED INFECTIONBY MYCOBACTERIUM-AVIUM COMPLEX

A patient with chronic myeloid leukemia (CML) who developed a dissemin ated infection by mycobacterium avium complex (MAC) was successfully t reated with rifampin, ethambutol, isoniazid, cycloserine and ciproflox acin. Diagnosis was proven by histologic examination of hepatic biopsy and culture of the liver biopsy material. Two years later the patient underwent allogeneic bone marrow transplantation (BMT) from an HLA-ma tched sibling donor, Antimycobacterial prophylaxis to MAC with ethambu tol, cycloserine and ciprofloxacin was given throughout the immediate post-transplant period, On day +25 post-BMT secondary prophylaxis was changed to ciprofloxacin and clarithromycin due to hepatic toxicity. T reatment was maintained until day 100 without side effects. There was no evidence of recurrent mycobacteriosis. Eight months after BMT the p atient is well, with a good performance status and chronic graft-versu s-host disease (GVHD) limited to the oral mucosa. Thus, MAC infection prior to transplant need not be a contraindication to successful BMT.