Voriconazole in the management of invasive aspergillosis in two patients with acute myeloid leukemia undergoing stem cell transplantation.
The management of invasive aspergillosis in patients with hematological malignancies remains controversial. A major problem is how to manage patients who had invasive aspergillosis during remission induction and consolidation therapy and then undergo SCT. Indeed in these patients the mortality rate related to invasive aspergillosis recurrence remains unacceptably high. We report two cases of patients who underwent remission induction for AML, developed invasive aspergillosis during antifungal prophylaxis with itraconazole, failed amphotericin B deoxycholate and liposomal amphotericin B treatment, were successfully treated with voriconazole and eventually underwent SCT with voriconazole prophylaxis without reactivation of invasive aspergillosis.
Mattei
D
D
Hematology Department, S Croce Hospital, Cuneo, Italy.
Mordini
N
N
Lo Nigro
C
C
Ghirardo
D
D
Ferrua
M T
MT
Osenda
M
M
Gallamini
A
A
Bacigalupo
A
A
Viscoli
C
C
D000328:Adult; D000666:Amphotericin B / Q000008:administration & dosage / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D001228:Aspergillosis / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D003131:Combined Modality Therapy; D003561:Cytarabine / Q000008:administration & dosage / Q000009:adverse effects; D003630:Daunorubicin / Q000008:administration & dosage / Q000009:adverse effects; D003840:Deoxycholic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004338:Drug Combinations; D025141:Drug Resistance, Fungal; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D017809:Fatal Outcome; D006801:Humans; D016867:Immunocompromised Host; D017964:Itraconazole / Q000627:therapeutic use; D007947:Leukemia, Megakaryoblastic, Acute / Q000150:complications / Q000188:drug therapy / Q000628:therapy*; D015479:Leukemia, Myelomonocytic, Acute / Q000150:complications / Q000188:drug therapy / Q000628:therapy*; D008081:Liposomes; D008172:Lung Diseases, Fungal / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects*; D011743:Pyrimidines / Q000627:therapeutic use*; D012008:Recurrence; D012074:Remission Induction; D016879:Salvage Therapy; D019172:Transplantation Conditioning / Q000009:adverse effects; D014182:Transplantation, Autologous / Q000009:adverse effects; D014184:Transplantation, Homologous / Q000009:adverse effects; D014230:Triazoles / Q000627:therapeutic use*; D065819:Voriconazole
D004338:Drug Combinations; D008081:Liposomes; D011743:Pyrimidines; D014230:Triazoles; C068538:liposomal amphotericin B; D003840:Deoxycholic Acid; D003561:Cytarabine; D017964:Itraconazole; D005047:Etoposide; D000666:Amphotericin B; C059765:amphotericin B, deoxycholate drug combination; D065819:Voriconazole; D003630:Daunorubicin