Linked Life Data

17933709

Source:http://linkedlifedata.com/resource/pubmed/id/17933709

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
8
pubmed:dateCreated
2007-10-15
pubmed:abstractText
Systemic candidiasis is a rare but life threatening complication in immunosuppressed patients undergoing allogeneic SCT. Combination of new antifungal agents may improve outcome in this patient population. Here, triple anti-mycotic therapy is described in an relapsed ALL patient in urgent need of allogeneic bone marrow transplantation. The patient with T-cell acute lymphoblastic leukemia of thymic differentiation achieved remission after treatment according to the German ALL protocol 07/03. Two months after the consolidation therapy relapse occurred requiring high dose chemotherapy with allogeneic stem cell transplantation. One day after start of the conditioning regimen the patient showed skin manifestations typical for septic mycosis and blood cultures became positive for Candida krusei while on fluconazole prophylaxis. Because of the limited sensibility of fluconazole resistant candida species to liposomal amphotericin B and the high mortality rate in patients with systemic candidiasis, voriconazole was added immediately to liposomal amphotericin B. Since fever did not resolve and the conditioning therapy for allogeneic transplantation was not yet completed caspofungin was added. Skin manifestation responded to this triple anti-mycotic combination and peripheral blood stem cells from an unrelated donor were transplanted. With the triple antifungal therapy the patient finally became afebrile, skin manifestations showed complete resolution and blood cultures became negative. Three months after the onset of systemic candidiasis the patient was fully active with no signs of fungal infection and in haematological and molecular remission. Mycotic sepsis at the start of myeloablative conditioning therapy in heavily pretreated acute leukemia patients is usually considered as not allowing successful allogeneic transplantation. Thus this case demonstrates, that allogeneic stem cell transplantation is feasible in patients presenting with systemic candidiasis if combined antifungal therapy with liposomal amphotericin B, caspofungin and voriconazole is given.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Aug
pubmed:issn
0949-2321
pubmed:author
pubmed:issnType
Print
pubmed:day
16
pubmed:volume
12
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
337-40
pubmed:dateRevised
2007-11-15
pubmed:meshHeading
pubmed-meshheading:17933709-Adult, pubmed-meshheading:17933709-Amphotericin B, pubmed-meshheading:17933709-Antifungal Agents, pubmed-meshheading:17933709-Antineoplastic Combined Chemotherapy Protocols, pubmed-meshheading:17933709-Bone Marrow Transplantation, pubmed-meshheading:17933709-Candidiasis, pubmed-meshheading:17933709-Drug Therapy, Combination, pubmed-meshheading:17933709-Echinocandins, pubmed-meshheading:17933709-Hematopoietic Stem Cell Transplantation, pubmed-meshheading:17933709-Humans, pubmed-meshheading:17933709-Immunocompromised Host, pubmed-meshheading:17933709-Leukemia-Lymphoma, Adult T-Cell, pubmed-meshheading:17933709-Liposomes, pubmed-meshheading:17933709-Male, pubmed-meshheading:17933709-Peptides, Cyclic, pubmed-meshheading:17933709-Pyrimidines, pubmed-meshheading:17933709-Transplantation, Homologous, pubmed-meshheading:17933709-Transplantation Conditioning, pubmed-meshheading:17933709-Triazoles
pubmed:year
2007
pubmed:articleTitle
Triple antifungal therapy for severe systemic candidiasis allowed performance of allogeneic stem cell transplantation.
pubmed:affiliation
Division of Stem Cell Transplantation and Immunotherapy, 2nd Department of Medicine, University Medical Center SH Campus Kiel, Kiel, Germany. B.Gahn@med2.uni-kiel.de
pubmed:publicationType
Journal Article, Case Reports