Pediatric Philadelphia chromosome-positive acute lymphoblastic leukemia complicated by immune reconstitution inflammatory syndrome due to Pneumocystis pneumonia following hematopoietic cell transplantation

Abstract

 Immune Reconstitution Inflammatory Syndrome (IRIS) is a complication that develops after anti-HIV treatment in patients with HIV (human immunodeficiency virus) /AIDS (acquired immunodeficiency syndrome) after anti-HIV treatment. This phenomenon is known as immune recovery aggravating an existing infection. IRIS can also occur after chemotherapy or organ transplantation. This report describes the case of a 10-year-old boy with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph＋ALL). He developed Candida parapsilosis infection after bone marrow transplantation, which was followed by Pneumocystis pneumonia. While the patient’s immune system recovered, his condition progressed to respiratory failure due to excessive inflammation. His symptoms improved with respiratory management and steroid therapy. IRIS is characterized by worsening inflammation in specific infections and affected organs, with a particularly high risk during invasive fungal infection. The diagnosis and early treatment of IRIS are important, and the use of appropriate steroid therapy is crucial.