Successful treatment of Trichosporon fungemia in a patient with refractory acute myeloid leukemia using voriconazole combined with liposomal amphotericin B
Successful treatment of Trichosporon fungemia in a patient with refractory acute myeloid leukemia using voriconazole combined with liposomal amphotericin B
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DOI：
10.1111/j.1399-3062.2011.00670.x
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发表时间：
2012-04-01
影响因子：
2.6
通讯作者：
Nakao, S.
中科院分区：
文献类型：
--
作者：
Hosokawa, K.;Yamazaki, H.;Nakao, S.
丝孢酵母菌血症是一种罕见的和致命的真菌感染，发生在与血液系统恶性肿瘤相关的长期中性粒细胞减少症患者。一名21岁男性急性髓性白血病（AML）缓解诱导治疗期间发生丝孢酵母菌血症。虽然两个疗程的诱导治疗未能诱导AML缓解，但伏立康唑和脂质体阿霉素B（L-Am B）联合治疗后，单核细胞集落刺激因子改善了丝孢酵母菌属真菌血症，并使患者能够接受来自其人类白细胞抗原-A单位点错配母亲的低强度骨髓移植（BMT）。该患者在骨髓移植后获得了持久缓解，而没有加重丝孢酵母菌血症。因此，伏立康唑和L-AmB的联合治疗可能有助于控制AML缓解诱导治疗后与长期中性粒细胞减少相关的丝孢酵母菌血症。
Trichosporon fungemia is a rare and fatal fungal infection that occurs in patients with prolonged neutropenia associated with hematologic malignancies. A 21-year-old male developed Trichosporon fungemia during remission induction therapy for acute myeloid leukemia (AML). Although two courses of induction therapy failed to induce a remission of AML, combination therapy with voriconazole and liposomal amphotericin B (L-AmB) followed by monocyte colony-stimulating factor ameliorated the Trichosporon fungemia and enabled the patient to receive reduced-intensity bone marrow transplantation (BMT) from his human leukocyte antigen-A one-locus mismatched mother. The patient achieved a durable remission after BMT without exacerbation of Trichosporon fungemia. The combination therapy with voriconazole and L-AmB may therefore be useful in controlling Trichosporon fungemia associated with prolonged neutropenia after remission induction therapy for AML.