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Eibl, M; Auner, HW; Zinke-Cerwenka, W; Sill, H; Dornbusch, HJ; Linkesch, W.
High-risk AML complicated by pulmonary aspergillosis: successful treatment with nonmyeloablative stem cell transplantation and long-term administration of voriconazole.
ANN HEMATOL. 2004; 83(2): 133-136. Doi: 10.1007/s00277-003-0782-2 (- Case Report)
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Führende Autor*innen der Med Uni Graz
Eibl Margit
Co-Autor*innen der Med Uni Graz
Dornbusch Hans Jürgen
Linkesch Werner
Sill Heinz
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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 Desmopressin substitution for DI was withdrawn after transplant without recurrence of symptoms.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.
Find related publications in this database (using NLM MeSH Indexing)
Adult -
Antifungal Agents - administration and dosage
Aspergillosis - complications
Female - complications
Humans - complications
Leukemia, Myelocytic, Acute - microbiology
Lung Diseases, Fungal - drug therapy
Myeloablative Agonists - therapeutic use
Pyrimidines - administration and dosage
Radiography, Thoracic - administration and dosage
Stem Cell Transplantation - administration and dosage
Tomography, X-Ray Computed - administration and dosage
Transplantation Conditioning - methods
Triazoles - administration and dosage

Find related publications in this database (Keywords)
AML
diabetes insipidus
aspergillosis
voriconazole
nonmyeloablative stem cell transplantation
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