title: Successful treatment of Trichosporon fungemia in a patient with refractory acute myeloid leukemia using voriconazole combined with liposomal amphotericin B.
abstract: Trichosporon fungemia is a rare and fatal fungal infection that occurs in patients with prolonged neutropenia associated with hematologic malignancies. A 21-year-old male developed Trichosporon fungemia during remission induction therapy for acute myeloid leukemia (AML). Although two courses of induction therapy failed to induce a remission of AML, combination therapy with voriconazole and liposomal amphotericin B (L-AmB) followed by monocyte colony-stimulating factor ameliorated the Trichosporon fungemia and enabled the patient to receive reduced-intensity bone marrow transplantation (BMT) from his human leukocyte antigen-A one-locus mismatched mother. The patient achieved a durable remission after BMT without exacerbation of Trichosporon fungemia. The combination therapy with voriconazole and L-AmB may therefore be useful in controlling Trichosporon fungemia associated with prolonged neutropenia after remission induction therapy for AML.
authors.affiliation: Cellular Transplantation Biology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan. hosokawa@med3.m.kanazawa-u.ac.jp
authors.forename: K
authors.initials: K
authors.lastname: Hosokawa
authors.forename: H
authors.initials: H
authors.lastname: Yamazaki
authors.forename: K
authors.initials: K
authors.lastname: Mochizuki
authors.forename: K
authors.initials: K
authors.lastname: Ohata
authors.forename: K
authors.initials: K
authors.lastname: Ishiyama
authors.forename: T
authors.initials: T
authors.lastname: Hayashi
authors.forename: Y
authors.initials: Y
authors.lastname: Kondo
authors.forename: N
authors.initials: N
authors.lastname: Sugimori
authors.forename: H
authors.initials: H
authors.lastname: Okumura
authors.forename: A
authors.initials: A
authors.lastname: Takami
authors.forename: S
authors.initials: S
authors.lastname: Nakao
mesh_terms: D000666:Amphotericin B / Q000008:administration & dosage / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use; D016026:Bone Marrow Transplantation; D004359:Drug Therapy, Combination; D017809:Fatal Outcome; D016469:Fungemia / Q000382:microbiology*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000150:complications*; D008297:Male; D011743:Pyrimidines / Q000008:administration & dosage / Q000627:therapeutic use*; D014230:Triazoles / Q000008:administration & dosage / Q000627:therapeutic use*; D014250:Trichosporon / Q000302:isolation & purification*; D060586:Trichosporonosis / Q000150:complications*; D065819:Voriconazole; D055815:Young Adult
chemical_list: D000935:Antifungal Agents; D011743:Pyrimidines; D014230:Triazoles; C068538:liposomal amphotericin B; D000666:Amphotericin B; D065819:Voriconazole