title: Zygomycosis in relapsed acute leukaemia.
abstract: We would like to report the use of liposomal amphotericin in eradicating mucormycosis in two patients who had relapsed acute leukaemia. The first patient with relapsed acute myeloid leukaemia developed a rapidly expanding solitary necrotic neck lesion associated with opacity of maxilliary sinus at a time when he was profoundly pancytopenic following high dose chemotherapy. The second patient was a 3-year-old boy with pre-B acute lymphoblastic leukaemia who developed a central nervous system relapse whilst on his first line treatment and was treated with more aggressive chemotherapy on the Medical Research Council Relapse Protocol. During a period of profound pancytopenia following re-induction therapy, including high dose steroids and prolonged course of antibiotics for proven septicaemia, he developed periorbital swelling and proptosis and a clinical diagnosis of rhinocerebral mucormycosis was made. Both patients were treated with high doses of liposomal amphotericin (Ambisome Nexstar). The doses were escalated to 10 and 15 mg/kg/day, resulting in successful eradication of the mucormycosis.
authors: Department of Paediatrics, Royal Devon and Exeter Hospital, Exeter, UK.
authors: T
authors: T
authors: Parkyn
authors: A W
authors: AW
authors: McNinch
authors: T
authors: T
authors: Riordan
authors: M
authors: M
authors: Mott
mesh_terms: D020095:Absidia / Q000302:isolation & purification; D000293:Adolescent; D000666:Amphotericin B / Q000008:administration & dosage / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002675:Child, Preschool; D006801:Humans; D016867:Immunocompromised Host; D015470:Leukemia, Myeloid, Acute / Q000150:complications*; D008297:Male; D009091:Mucormycosis / Q000150:complications / Q000188:drug therapy; D009894:Opportunistic Infections / Q000150:complications / Q000188:drug therapy*; D015452:Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications*; D012008:Recurrence; D020096:Zygomycosis / Q000150:complications / Q000188:drug therapy*
chemical_list: D000935:Antifungal Agents; C068538:liposomal amphotericin B; D000666:Amphotericin B