Successful antifungal combination therapy with voriconazole and caspofungin.
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.
Schuster
Friedhelm
F
Division of Pediatric Hematology/Oncology, Dr. v. Haunersches Kinderspital, LMU-University of Munich, Munich, Germany. Friedhelm.Schuster@med.uni-muenchen.ole
Moelter
Christian
C
Schmid
Irene
I
Graubner
Ulrike B
UB
Kammer
Birgit
B
Belohradsky
Bernd H
BH
Führer
Monika
M
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
D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D010456:Peptides, Cyclic; D011743:Pyrimidines; D014230:Triazoles; D000077336:Caspofungin; D065819:Voriconazole