Cure of pulmonary Rhizomucor pusillus infection in a patient with hairy-cell leukemia: role of liposomal amphotericin B and GM-CSF.
We describe a case of successfully treated multifocal pulmonary Rhizomucor pusillus, a condition which has previously been universally fatal. A 77 year-old man had a background of chronic neutropenia due to hairy-cell leukemia, splenectomy, corticosteroid therapy and an obstructing left ureteric transitional-cell carcinoma. He was successfully treated with 3 months of high-dose liposomal amphotericin B and 7 months of granulocyte-macrophage colony-stimulating factor. Treatment was complicated by mild reversible deterioration of renal function. There was a near complete radiological response to the therapy at 6 months and the patient remains well 20 months following diagnosis of R. pusillus and 13 months following cessation of treatment.
Ma
B
B
Department of Haematology, Peter MacCallum Cancer Institute, Melbourne, Victoria, Australia.
Seymour
J F
JF
Januszewicz
H
H
Slavin
M A
MA
D000368:Aged; D000666:Amphotericin B / Q000008:administration & dosage*; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000008:administration & dosage*; D006801:Humans; D007943:Leukemia, Hairy Cell / Q000150:complications*; D008081:Liposomes; D008172:Lung Diseases, Fungal / Q000188:drug therapy*; D008297:Male; D009091:Mucormycosis / Q000188:drug therapy*; D020103:Rhizomucor
D008081:Liposomes; D016179:Granulocyte Colony-Stimulating Factor; D000666:Amphotericin B; D016178:Granulocyte-Macrophage Colony-Stimulating Factor