Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 26, 2024; 12(3): 623-629
Published online Jan 26, 2024. doi: 10.12998/wjcc.v12.i3.623
Carrimycin in the treatment of acute promyelocytic leukemia combined with pulmonary tuberculosis: A case report
Fu-Yu Yang, Lei Shao, Jie Su, Zhen-Meng Zhang
Fu-Yu Yang, Lei Shao, Jie Su, Zhen-Meng Zhang, Department of Infectious Diseases, The Affiliated Central Hospital of Shandong First Medical University, Jinan 250013, Shandong Province, China
Author contributions: Yang FY and Shao L contributed to manuscript writing; Su J contributed to data curation and review; Shao L and Zhang ZM contributed to manuscript and figure editing; All authors have read and approved the final manuscript.
Informed consent statement: Written informed consent was obtained from the patient to publish this paper.
Conflict-of-interest statement: The authors declare having no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lei Shao, MD, PhD, Chief Physician, Doctor, Department of Infectious Diseases, The Affiliated Central Hospital of Shandong First Medical University, No. 105 Jiefang Road, Lixia District, Jinan 250013, Shandong Province, China. shaolei0328@163.com
Received: November 22, 2023
Peer-review started: November 22, 2023
First decision: December 8, 2023
Revised: December 17, 2023
Accepted: January 4, 2024
Article in press: January 4, 2024
Published online: January 26, 2024
Processing time: 57 Days and 0.1 Hours
Abstract
BACKGROUND

Pulmonary tuberculosis (PTB) is prevalent in immunocompromised populations, including patients with hematologic malignancies, human immunodeficiency virus infections, and chronic diseases. Effective treatment for acute promyelocytic leukemia (APL) combined with PTB is lacking. These patients show an extremely poor prognosis. Therefore, studies should establish efficient treatment options to improve patient survival and prognosis.

CASE SUMMARY

A 60-year-old male with pain in the right side of his chest and a fever for 4 d visited the outpatient department of our hospital. Peripheral blood smear revealed 54% blasts. Following bone marrow examinations, variant APL with TNRC18-RARA fusion gene was diagnosed. Chest computed tomography scan showed bilateral pneumonitis with bilateral pleural effusions, partial atelectasis in the lower lobes of both lungs, and the bronchoalveolar lavage fluid gene X-Pert test was positive, indicative of PTB. Carrimycin, ethambutol (EMB), and isoniazid (INH) were administered since he could not receive chemotherapy as the WBC count decreased continuously. After one week of treatment with carrimycin, the patient recovered from fever and received chemotherapy. Chemotherapy was very effective and his white blood cells counts got back to normal. After being given five months with rifampin, EMB and INH and chemotherapy, the patient showed complete remission from pneumonia and APL.

CONCLUSION

We report a case of PTB treated successfully with carrimycin with APL that requires chemotherapy.

Keywords: Carrimycin; Hematologic disease; Acute myeloid leukemia; Acute promyelocytic leukemia; Pulmonary tuberculosis; Case report

Core Tip: Here, we report a case of a patient with acute promyelocytic leukemia (APL) combined with pulmonary tuberculosis (PTB). Addition of carrimycin in a patient with tuberculosis in remission thus enabling chemotherapy for leukemia. He could not tolerate the side effects of routine anti- tuberculosis drugs because of a low white blood cell count, so carrimycin was used for treatment for PTB. He achieved complete remission of APL and PTB after six months treatment. Further research is necessary to determine whether carrimycin is therapeutically useful in PTB.