Successful micafungin (FK463) treatment of invasive pulmonary aspergillosis in a patient with acute lymphoblastic leukemia in a phase II study.
We treated a 52-year-old woman with acute lymphoblastic leukemia (ALL) who developed invasive pulmonary aspergillosis (IPA) as a result of neutropenia following remission-induction chemotherapy. Although serological test results, such as those for platelia and pastrex, were all negative and the serum level of beta-D-glucan was low, Aspergillus DNA was detected in blood by the polymerase chain reaction method. A clinically documented diagnosis of IPA was made on the basis of chest x-rays, computed tomography scan findings, and the detection of Aspergillus DNA. Micafungin (FK463), a candin class antifungal agent, was administered at a dose of 75 to 150 mg/day, because other antifungal agents were not effective. The increase in serum concentration of micafungin was dose-dependent and was accompanied by improvement of symptoms and objective findings. Micafungin was effective for the treatment of IPA in this patient with ALL.
Ota
Shuichi
S
Department of Internal Medicine, Gastroenterology and Hematology Section, Hokkaido University Graduate School of Medicine, Sapporo, Japan. shuota@med.hokudai.ac.jp
Tanaka
Junji
J
Kahata
Kaoru
K
Toubai
Tomomi
T
Kondo
Keiichi
K
Mori
Akio
A
Toyoshima
Nobuyasu
N
Musashi
Manabu
M
Asaka
Masahiro
M
Imamura
Masahiro
M
D000970:Antineoplastic Agents / Q000009:adverse effects; D001228:Aspergillosis / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D017322:Clinical Trials, Phase II as Topic; D054714:Echinocandins; D005260:Female; D006801:Humans; D055666:Lipopeptides; D008074:Lipoproteins / Q000493:pharmacokinetics / Q000627:therapeutic use*; D008172:Lung Diseases, Fungal / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D000077551:Micafungin; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced / Q000150:complications; D009894:Opportunistic Infections / Q000175:diagnosis / Q000188:drug therapy; D010456:Peptides, Cyclic / Q000493:pharmacokinetics / Q000627:therapeutic use*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications*; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D054714:Echinocandins; D055666:Lipopeptides; D008074:Lipoproteins; D010456:Peptides, Cyclic; D000077551:Micafungin