title: Hepatosplenic Candidiasis, its Treatment and Effect on Remission Status in Patients with Acute Leukaemia-a Report of Five Cases.
abstract: Hepatosplenic candidiasis is an increasingly encountered complication of treatment of patients with acute leukaemia [[1] Clin. Infect. Dis. 24 (1997) 375]. Management is difficult as delay in further chemotherapy may allow relapse of the leukaemia while the infection may progress if chemotherapy is continued [[2] Anticancer Res. 19 (1999) 757]. We report five cases of suspected hepatosplenic candidiasis in a single haematology unit over a 30-month period. All patients were treated with oral fluconazole following intravenous amphotericin or liposomal amphotericin B lipid complex. Chemotherapy was withheld during treatment of infection. Two patients remain in haematological remission despite suboptimal therapy for their leukaemia. One patient died from progressive fungal infection, 1 patient of cardiac disease and 1 patient has had recent relapse of their leukaemia. We demonstrate that hepatosplenic candidiasis may be treated with oral fluconazole while chemotherapy is discontinued and also suggest that this infection or its treatment may have had a beneficial immunomodulatory affect on the leukaemic process in the surviving patients.
authors.affiliation: a Department of Haematology , Royal Victoria Hospital , Lisburn Road, Belfast BT 9 7AB , Northern Ireland , UK.
authors.forename: J W
authors.initials: JW
authors.lastname: Hamilton
authors.affiliation: a Department of Haematology , Royal Victoria Hospital , Lisburn Road, Belfast BT 9 7AB , Northern Ireland , UK.|b The Queens University of Belfast , Belfast BT 9 7AB , Northern Ireland , UK.
authors.forename: M F
authors.initials: MF
authors.lastname: McMullin
authors.affiliation: a Department of Haematology , Royal Victoria Hospital , Lisburn Road, Belfast BT 9 7AB , Northern Ireland , UK.
authors.forename: F
authors.initials: F
authors.lastname: Jones
keywords: Acute leukaemia; Candidiasis; Chemotherapy; Complications; Hepatosplenic