ABSTRACT
BACKGROUND: Allergic bronchopulmonary mycosis (ABPM) is an allergic disease caused by type I and type III hypersensitivity to environmental fungi. Schizophyllum commune, a basidiomycete fungus, is one of the most common fungi that causes non-Aspergillus ABPM. OBJECTIVE: Herein, we attempted to clarify the clinical characteristics of ABPM caused by S. commune (ABPM-Sc) compared with those of allergic bronchopulmonary aspergillosis (ABPA). METHODS: Patients with ABPM-Sc or ABPA were recruited from a nationwide survey in Japan, a multicenter cohort, and a fungal database at the Medical Mycology Research Center of Chiba University. The definition of culture-positive ABPM-Sc/ABPA is as follows: (1) fulfills five or more of the 10 diagnostic criteria for ABPM proposed by Asano et al., and (2) positive culture of S. commune/Aspergillus spp. in sputum, bronchial lavage fluid, or mucus plugs in the bronchi. RESULTS: Thirty patients with ABPM-Sc and 46 with ABPA were recruited. Patients with ABPM-Sc exhibited less severe asthma and presented with better pulmonary function than those with ABPA (p = 0.008-0.03). Central bronchiectasis was more common in ABPM-Sc than that in ABPA, whereas peripheral lung lesions, including infiltrates/ground-glass opacities or fibrotic/cystic changes, were less frequent in ABPM-Sc. Aspergillus fumigatus-specific immunoglobulin (Ig)E was negative in 10 patients (34%) with ABPM-Sc, who demonstrated a lower prevalence of asthma and levels of total serum IgE than those with ABPM-Sc positive for A. fumigatus-specific IgE or ABPA. CONCLUSIONS: Clinical characteristics of ABPM-Sc, especially those negative for A. fumigatus-specific IgE, differed from those of ABPA.
ABSTRACT
The prognosis is poor for patients with advanced pleomorphic carcinoma of the lung due to the generally limited response to chemotherapy and/or radiotherapy. It has been suggested the production of granulocyte colony-stimulating factor (G-CSF) by cancer cells may aggravate the disease progression. We herein report a case of a 73-year-old Japanese man with advanced G-CSF-producing pleomorphic carcinoma of the lung. First-line chemotherapy with carboplatin and paclitaxel had been suspended. Subsequent radiotherapy achieved a moderate volume reduction and an amelioration of the excessive G-CSF-related complications. Six cycles of second-line chemotherapy with docetaxel administered with good results. These combined treatments resulted in long term survival without progression of the disease.
Subject(s)
Carcinoma/drug therapy , Carcinoma/radiotherapy , Granulocyte Colony-Stimulating Factor/metabolism , Lung Neoplasms/drug therapy , Lung Neoplasms/radiotherapy , Aged , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Carcinoma/diagnosis , Combined Modality Therapy , Humans , Lung Neoplasms/diagnosis , Male , Remission Induction , Time FactorsABSTRACT
INTRODUCTION: There is no clear answer as to how long we should continue aggressive treatment for progressive lung cancer. PURPOSE: An ideal way to conduct and discontinue aggressive treatment was examined from the viewpoint of quality of life and the remaining lifespan after treatment discontinuation. MATERIAL & METHODS: We began systemic chemotherapy and/or radiotherapy from January 2003 to December 2007, based on our pathological diagnosis of lung cancer. Then, in 30 patients who thereafter stopped aggressive treatment, we retrospectively investigated the content and period of aggressive treatment, and clinical presentation before and after they discontinued their treatment. In addition, the factors important for quality of life and the prognosis after the treatment discontinuation were analyzed. RESULT: For quality of life and the remaining lifespan after the treatment discontinuation, it was found important to avoid serious adverse effects of treatment and watch out for performance status decrease during the treatment period. Then, after the treatment discontinuation, it was thought to be important to pay attention not only to the cancer progression but also the complications arising from other diseases including pneumonia.
