Successful treatment of invasive aspergillosis in chronic granulomatous disease by bone marrow transplantation, granulocyte colony-stimulating factor-mobilized granulocytes, and liposomal amphotericin-B

Détails

ID Serval
serval:BIB_1C6E6BE7B9BD
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Etude de cas (case report): rapporte une observation et la commente brièvement.
Collection
Publications
Institution
Titre
Successful treatment of invasive aspergillosis in chronic granulomatous disease by bone marrow transplantation, granulocyte colony-stimulating factor-mobilized granulocytes, and liposomal amphotericin-B
Périodique
Blood
Auteur⸱e⸱s
Ozsahin  H., von Planta  M., Muller  I., Steinert  H. C., Nadal  D., Lauener  R., Tuchschmid  P., Willi  U. V., Ozsahin  M., Crompton  N. E., Seger  R. A.
ISSN
0006-4971
Statut éditorial
Publié
Date de publication
10/1998
Peer-reviewed
Oui
Volume
92
Numéro
8
Pages
2719-24
Notes
Case Reports
Journal Article --- Old month value: Oct 15
Résumé
X-linked chronic granulomatous disease (X-CGD) is a primary immunodeficiency with complete absence or malfunction of the nicotinamide adenine dinucleotide phosphate (NADPH) oxidase in the phagocytic cells. Life-threatening infections especially with aspergillus are common despite optimal antimicrobial therapy. Bone marrow transplantation (BMT) is contraindicated during invasive aspergillosis in any disease setting. We report an 8-year-old patient with CGD who underwent HLA-genoidentical BMT during invasive multifocal aspergillus nidulans infection, nonresponsive to treatment with amphotericin-B and gamma-interferon. During the first 10 days post-BMT, the patient received granulocyte colony-stimulating factor (G-CSF)-mobilized, 25 Gy irradiated granulocytes from healthy volunteers plus G-CSF beginning on day 3 to prolong the viability of the transfused granulocytes. This was confirmed in vitro by apoptosis assays and in vivo by finding nitroblue tetrazolium (NBT)-positive granulocytes in peripheral blood 12 and 36 hours after the transfusions. Clinical and biological signs of infection began to disappear on day 7 post-BMT. Positron emission tomography with F18-fluorodeoxyglucose (FDG-PET) and computed tomography (CT) scans at 3 months post-BMT showed complete disappearance of infectious foci. At 2 years post-BMT, the patient is well with full immune reconstitution and no sign of aspergillus infection. Our results show that HLA-identical BMT may be successful during invasive, noncontrollable aspergillus infection, provided that supportive therapy is optimal.
Mots-clé
Amphotericin B/administration & dosage/*therapeutic use Antifungal Agents/administration & dosage/*therapeutic use Apoptosis Aspergillosis/drug therapy/prevention & control/radionuclide imaging/*therapy *Aspergillus nidulans *Bone Marrow Transplantation Child Combined Modality Therapy Drug Carriers Graft Survival/drug effects Granulocyte Colony-Stimulating Factor/*therapeutic use Granulocytes/physiology Granulomatous Disease, Chronic/complications/*therapy Humans Itraconazole/therapeutic use Leukocyte Count *Leukocyte Transfusion Liposomes Lung Diseases, Fungal/drug therapy Male Tomography, Emission-Computed Treatment Outcome
Pubmed
Web of science
Création de la notice
24/01/2008 18:16
Dernière modification de la notice
20/08/2019 13:52
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