High-risk AML complicated by pulmonary aspergillosis: successful treatment with nonmyeloablative stem cell transplantation and long-term administration of voriconazole.

Details

Serval ID
serval:BIB_BAA9A4177C68
Type
Article: article from journal or magazin.
Collection
Publications
Title
High-risk AML complicated by pulmonary aspergillosis: successful treatment with nonmyeloablative stem cell transplantation and long-term administration of voriconazole.
Journal
Annals of hematology
Author(s)
Eibl M., Auner H.W., Zinke-Cerwenka W., Sill H., Dornbusch H.J., Linkesch W.
ISSN
0939-5555 (Print)
ISSN-L
0939-5555
Publication state
Published
Issued date
02/2004
Peer-reviewed
Oui
Volume
83
Number
2
Pages
133-136
Language
english
Notes
Publication types: Case Reports ; Journal Article
Publication Status: ppublish
Abstract
Acute myeloid leukemia (AML) associated with central diabetes insipidus (DI) and chromosomal aberrations is characterised by a very poor prognosis. We present a 28-year-old female with AML FAB M0, preceding DI and cytogenetic abnormalities (monosomy 7 and inversion of chromosome 9). Complete remission was achieved with FLAG after she was refractory to two different induction regimens. Prolonged neutropenia resulted in invasive pulmonary aspergillosis. Allogeneic stem cell transplantation from a matched unrelated donor was performed using a reduced-intensity conditioning regimen. Desmopressin substitution for DI was withdrawn after transplant without recurrence of symptoms. Initial antifungal treatment, including liposomal amphotericin B, caspofungin and itraconazole, was replaced by voriconazole after deterioration of pulmonary aspergillosis, resulting in improvement, stabilisation and finally, also as the combined effect of discontinuation of the immunosuppressive therapy, in disappearance of signs and symptoms. Thirteen months after transplant, the patient is in continuous complete remission. The presented case study thus demonstrates that high-risk AML with concomitant invasive fungal infection may be safely and effectively treated by nonmyeloablative stem cell transplantation and long-term administration of voriconazole.
Keywords
Adult, Antifungal Agents/administration & dosage, Aspergillosis/complications, Aspergillosis/drug therapy, Female, Humans, Leukemia, Myeloid, Acute/microbiology, Leukemia, Myeloid, Acute/pathology, Leukemia, Myeloid, Acute/therapy, Lung Diseases, Fungal/diagnostic imaging, Lung Diseases, Fungal/drug therapy, Myeloablative Agonists/therapeutic use, Pyrimidines/administration & dosage, Radiography, Thoracic, Stem Cell Transplantation, Tomography, X-Ray Computed, Transplantation Conditioning/methods, Triazoles/administration & dosage, Voriconazole
Pubmed
Web of science
Create date
02/12/2024 16:50
Last modification date
04/12/2024 7:07
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