Abstract
A case of ALL (acute lymphocytic leukemia), complicated with generalized cryptococcosis was treated successfully by amphotericin B.
A 63 years old woman had been febrile since February, 1983. A diagnosis of ALL (FAB; L2) was established and a remission induction chemotherapy with THP-adriamycin, vincristine and prednisolone was begun on March, 3. Thereafter she went into CR (complete remission) on May, 6, but generalized cryptococcosis developed. Cryptococci were found in blood, subcutaneous. tissue and cerebrospinal fluid. Amphotericin B and 5-fluorocytosine were administered, then meningitis and skin lesions were improved markedly. However, because of side effects, amphotericin B was replaced by ketoconazole or miconazole. Then, skin lesions were relapsed and brain small abscesses developed. Therefore, an administration of amphotericin B was restarted and generalized cryptococcosis was nearly cured. Seven months latter. amphotericin B was discontinued and no relapse of cryptococcosis was seen up to date.
CR for ALL was maintained by vincristine only throughout the course.
