title: Successful antifungal combination therapy with voriconazole and caspofungin.
abstract: A 12-year-old boy in third remission of an acute lymphoblastic leukaemia developed infection of lung and paranasal sinuses with Aspergillus flavus in neutropenia. Because of the high risk of leukaemia-relapse bone marrow transplantation (BMT) from a matched unrelated donor was carried out despite invasive pulmonary aspergillosis (IPA). It is the first reported patient with IPA, who was successfully treated by the antifungal combination therapy with voriconazole and caspofungin therapy during myeloablative BMT. Despite 6 weeks of aplasia, a dramatic decrease of lesions highly suggestive of aspergillosis was observed after BMT. Since discharge-oral voriconazole monotherapy has been continued.
authors.affiliation: Division of Pediatric Hematology/Oncology, Dr. v. Haunersches Kinderspital, LMU-University of Munich, Munich, Germany. Friedhelm.Schuster@med.uni-muenchen.ole
authors.forename: Friedhelm
authors.initials: F
authors.lastname: Schuster
authors.forename: Christian
authors.initials: C
authors.lastname: Moelter
authors.forename: Irene
authors.initials: I
authors.lastname: Schmid
authors.forename: Ulrike B
authors.initials: UB
authors.lastname: Graubner
authors.forename: Birgit
authors.initials: B
authors.lastname: Kammer
authors.forename: Bernd H
authors.initials: BH
authors.lastname: Belohradsky
authors.forename: Monika
authors.initials: M
authors.lastname: Führer
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use*; D001228:Aspergillosis / Q000150:complications / Q000188:drug therapy*; D001230:Aspergillus / Q000187:drug effects*; D000077336:Caspofungin; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D054714:Echinocandins; D006801:Humans; D055666:Lipopeptides; D008172:Lung Diseases, Fungal / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D010456:Peptides, Cyclic / Q000627:therapeutic use; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000382:microbiology* / Q000473:pathology / Q000628:therapy*; D011743:Pyrimidines / Q000627:therapeutic use; D014230:Triazoles / Q000627:therapeutic use; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D010456:Peptides, Cyclic; D011743:Pyrimidines; D014230:Triazoles; D000077336:Caspofungin; D065819:Voriconazole