A 68-year-old female patient with myelofibrosis was admitted for scheduled matched
unrelated donor allogeneic hematopoietic stem cell transplant for the treatment of
myelofibrosis. Her past medical history was also significant for Grover disease, also
known as transient acantholytic dermatosis, characterized by chronic pruritic skin
eruptions. On admission, the patient had no complaints with stable vital signs and
benign physical examination. Laboratory values were notable for anemia with hemoglobin
of 8.33g/dL, white blood cell count of 7.22 k/uL, and platelet count of 297 k/uL.
Upon admission, the patient received conditioning chemotherapy with melphalan and
flucytosine followed by stem cell transplant on hospitalization day 5. Graft-versus-host
disease prophylaxis consisted of post-transplant cyclophosphamide, tacrolimus, and
mycophenolate. In terms of antimicrobial agents, prophylactic acyclovir was initiated
on admission. Both ciprofloxacin and micafungin were initiated on post-transplant
day 4 at the onset of severe neutropenia (absolute neutrophil count of 380 cells/uL).
Micafungin was transitioned to oral voriconazole 200 mg twice daily on post-transplant
day 6.
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Article info
Publication history
Published online: September 20, 2022
Uma Paniker, MD, Section EditorFootnotes
Funding: None.
Conflicts of Interest: None.
Authorship: All authors had access to the data and a role in writing this manuscript.
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© 2022 Elsevier Inc. All rights reserved.
