Abstract
Two cases of refractory acute lymphoblastic leukemia with pulmonary aspergillosis were reported. Both cases died in spite of antifungal therapy. At the autopsy, massive infiltration of aspergillus without any cellular responses was found in their lungs. The analysis of 30 cases of reported childhood leukemia and malignant lymphoma with pulmonary aspergillosis, including the present two cases, revealed the following : (1) acute leukemia as the most prevalent of the primary diseases, (2) the frequent prophylaxis with antifungal agents, (3) higher survival rate in remission state of primary diseases, (4) development of aspergilloma and its surgical resection in most of the survival cases, (5) intravenous AMPH-B therapy in most of the survival cases, (6) massive hemothorax as the major cause of death in remission, and (7) definite diagnosis of pulmonary aspergillosis only by the resection or autopsy in most cases. These findings indicate the importance of reliable prophylaxis and early diagnosis of aspergillosis.
