Fatal Disseminated Tuberculosis and Concurrent Disseminated Cryptococcosis in a Ruxolitinib-treated Patient with Primary Myelofibrosis: A Case Report and Literature Review.

Ruxolitinib, a Janus kinase inhibitor, improves symptoms in patients with myelofibrosis. However, its association with the development of opportunistic infections has been a concern. We herein report a 71-year-old man with primary myelofibrosis who developed disseminated tuberculosis and concurrent disseminated cryptococcosis during ruxolitinib treatment. We also reviewed the literature on disseminated tuberculosis and/or cryptococcosis associated with ruxolitinib treatment. This is the first case of disseminated tuberculosis and concurrent disseminated cryptococcosis during treatment with ruxolitinib. We therefore suggest considering not only disseminated tuberculosis but also cryptococcosis in the differential diagnosis of patients with abnormal pulmonary shadows during ruxolitinib treatment.

Successful Stabilization of Symptomatic Bone Marrow Metastasis Two Times in a Breast Cancer Patient.

BACKGROUND: Bone marrow metastasis is very uncommon in breast cancer. Cancer patients showing a dramatic response to chemotherapy with full recovery are very rare. CASE REPORT: This is a case report of a 62-year-old woman who underwent partial mastectomy six years previously. The patient presented with increased fatigue and her hemoglobin level was 6.7 g/dl. Pathological examination of a bone marrow biopsy showed metastasis from breast cancer. Systemic therapy was initiated with doxorubicin and cyclophosphamide and pancytopenia was steadily improved. However, 15 months later, she felt severe fatigue again. Eribulin was administered and the patient showed sufficient recovery. She had two bone marrow metastases that caused pancytopenia including severe anemia. However, she survived twice with chemotherapy. CONCLUSION: Bone marrow metastasis of breast cancer is life-threatening; however, chemotherapy may significantly improve survival.