scholarly journals Invasive Pulmonary Aspergillosis after Recent Influenza in a Child with Acute Myeloid Leukemia

2015 ◽  
Vol 22 (2) ◽  
pp. 190-194
Author(s):  
Beom-Joon Kim ◽  
Seong koo Kim ◽  
Seung Beom Han ◽  
Jae Wook Lee ◽  
Jong-Seo Yoon ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Invasive Pulmonary Aspergillosis ◽  
Pulmonary Aspergillosis ◽  
Acute Myeloid

scholarly journals Invasive aspergillosis with disseminated skin ınvolvement in a patient with acute myeloid leukemia: a rare case

2017 ◽  
Vol 9 (2) ◽  
Author(s):  
Duygu Mert ◽  
Gülşen Iskender ◽  
Fazilet Duygu ◽  
Alparslan Merdin ◽  
Mehmet Sinan Dal ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Invasive Aspergillosis ◽  
Myeloid Leukemia ◽  
Rare Case ◽  
Invasive Pulmonary Aspergillosis ◽  
Skin Lesions ◽  
Immunocompromised Patients ◽  
Skin Involvement ◽  
Pulmonary Aspergillosis ◽  
Acute Myeloid

Invasive pulmonary aspergillosis is most commonly seen in immunocompromised patients. Besides, skin lesions may also develop due to invasive aspergillosis in those patients. A 49-year-old male patient was diagnosed with acute myeloid leukemia. The patient developed bullous and zosteriform lesions on the skin after the 21st day of hospitalization. The skin biopsy showed hyphae. Disseminated skin aspergillosis was diagnosed to the patient. Voricanazole treatment was initiated. The patient was discharged once the lesions started to disappear.

Thoracoscopic Lingulectomy for Invasive Pulmonary Aspergillosis

2007 ◽  
Vol 73 (3) ◽  
pp. 279-280 ◽  
Author(s):  
Bryan A. Whitson ◽  
Michael A. Maddaus ◽  
Rafael S. Andrade
Keyword(s):  
Acute Myeloid Leukemia ◽  
Mortality Rate ◽  
Myeloid Leukemia ◽  
Immunocompromised Patient ◽  
Lung Resection ◽  
Invasive Pulmonary Aspergillosis ◽  
Immunocompromised Patients ◽  
Anatomic Resection ◽  
Pulmonary Aspergillosis ◽  
Acute Myeloid

Invasive pulmonary aspergillosis (IPA) is associated with a high mortality rate in immunocompromised patients. Surgery has a therapeutic role for selected patients when the main objective is to achieve infection control with minimal lung resection. Large or deep-seated lesions may require an anatomic resection such as segmentectomy, lobectomy, or pneumonectomy. Thoracoscopic lobectomy has been described as a treatment of localized IPA; however, thoracoscopic anatomic segmentectomy has not been reported until now. Herein, we describe a case of thoracoscopic lingulectomy for localized IPA in an immunocompromised patient: this operation minimized the delay in resuming therapy for the patient's underlying acute myeloid leukemia. Video-assisted thoracoscopic segmentectomy can be safely performed for localized IPA.

scholarly journals Fatal Invasive Pulmonary Aspergillosis in COVID-19 Patient with Acute Myeloid Leukemia in Iran

2020 ◽  
Vol 185 (6) ◽  
pp. 1077-1084
Author(s):  
Elahe Nasri ◽  
Parisa Shoaei ◽  
Bahareh Vakili ◽  
Hossein Mirhendi ◽  
Somayeh Sadeghi ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Invasive Pulmonary Aspergillosis ◽  
Pulmonary Aspergillosis ◽  
Acute Myeloid

scholarly journals THE EFFICACY OF POSACONAZOLE FOR PROPHYLAXIS OF INVASIVE MYCOSES IN PATIENTS WITH ACUTE MYELOID LEUKEMIA

2017 ◽  
pp. 118-124
Author(s):  
G. A. Klyasova ◽  
V. A. Okhmat ◽  
E. N. Parovichnikova ◽  
E. O. Gribanova ◽  
V. V. Troitskaya ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Median Duration ◽  
Myeloid Leukemia ◽  
De Novo ◽  
Invasive Pulmonary Aspergillosis ◽  
Chemotherapy Cycle ◽  
Pulmonary Aspergillosis ◽  
Invasive Mycoses ◽  
De Novo Aml ◽  
Acute Myeloid

Efficacy of posaconazole for prophylaxis was evaluated in 77 chemotherapy cycles in 59 patients with acute myeloid leukemia (AML) aged 39 (17–62) years from 2012  till 2017. Posaconazole was given in oral suspension 200 mg three times a day after meal during chemotherapy cycle or on 1st  day after the cycle. Administration of posaconazole predominated in patients with de novo AML (84.5%) on 1st induction cycles (66.3%). Neutropenia was present in all patients with median duration of 22 days. Median duration of prophylaxis was 21  (2–57)  days. Posaconazole prophylaxis was interrupted in 28  (36.4%) of 77 cases, mainly due to diarrhea (28.6%). In 17 (61%) of 28 cases prophylaxis was resumed within a median of 3 days. In 72 (93.5%) of cases duration of posaconazole prophylaxis was ≥ 7 days, in 5 (6.5%) cases < 7 days. Efficacy of prophylaxis was evaluated in cases of posaconazole duration ≥ 7 days. Invasive pulmonary aspergillosis (probable) was in 2 (2.7%) of 72 cases. Administration of posaconazole with duration ≥ 7 days was in 46 cases on chemotherapy cycle, in 26 cases – on first day after the cycle. Patients using Posaconazole after a course of chemotherapy in comparison with patients receiving the drug in the first days of the course had significantly less interruptions of prophylaxis (11,5% vs 41,3%, p=0.009) and a reduction in duration of Posaconazole using (19 days vs 27 days, p=0.007).One case of invasive aspergillosis was registered in each group.We confirmed the  efficacy of posaconazole  for prophylaxis of invasive mycoses  in patients  with AML. Administration of posaconazole prophylaxis on first day after the end of chemotherapy cycle results in saving of drug by reducing duration of posaconazole using by 8 days and does not increase the incidence of invasive mycoses.

Baseline Chest Computed Tomography for Early Diagnosis of Invasive Pulmonary Aspergillosis in Hemato-oncological Patients: A Prospective Cohort Study

2019 ◽  
Vol 69 (10) ◽  
pp. 1805-1808 ◽  
Author(s):  
Roni Bitterman ◽  
Emilia Hardak ◽  
Marina Raines ◽  
Anat Stern ◽  
Tzila Zuckerman ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Myeloid Leukemia ◽  
Early Diagnosis ◽  
Myeloid Leukemia ◽  
Invasive Pulmonary Aspergillosis ◽  
Newly Diagnosed ◽  
Pulmonary Aspergillosis ◽  
Chest Computed Tomography ◽  
Oncological Patients ◽  
Acute Myeloid

Abstract Invasive pulmonary aspergillosis (IPA) has dire consequences in hemato-oncological patients. We report our experience with performing routine baseline chest computed tomography for early diagnosis of IPA. We found high rates of proven or probable IPA diagnosed on admission among patients with newly diagnosed acute myeloid leukemia.

scholarly journals 986. Incidence of Invasive Fungal Infections in Previously Untreated Patients with Acute Myeloid Leukemia Receiving Venetoclax and Azacitadine

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S584-S584
Author(s):  
Tanit Phupitakphol ◽  
Tanner M Johnson ◽  
Diana Abbott ◽  
Jonathan Gutman ◽  
Daniel Pollyea ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Fungal Infections ◽  
Invasive Pulmonary Aspergillosis ◽  
Standard Of Care ◽  
Antifungal Prophylaxis ◽  
Invasive Fungal Infections ◽  
Significant Difference ◽  
The Impact ◽  
Acute Myeloid

Abstract Background Acute myeloid leukemia (AML) is associated with poor prognosis, particularly in elderly patients with co-morbidities. Low-intensity therapies like azacitidine (aza) were the standard of care and were associated with low response rates and limited survival. Combining venetoclax (ven) with aza demonstrated significant improvements in responses and survival compared to aza alone, and represents the new standard of care for this population. However, as a myelosuppressive regimen, infectious complications, especially invasive fungal infections (IFI), are a potential concern. The incidence of IFI and the role for antifungal prophylaxis have not been well defined for newly-diagnosed AML patients receiving ven/aza. Methods We conducted a retrospective cohort review of AML patients treated with ven/aza at the University of Colorado Hospital from January 2014 to August 2020. Duration of therapy was defined as the time from initiation of treatment through one of the following endpoints (1) patient discontinuation, (2) progression of disease, (3) bone marrow transplantation, or (4) death. Four patients with a history of prior IFI were excluded. We assessed the impact of patient age, sex, duration of neutropenia, antifungal prophylaxis, and AML specific risk factors on the incidence of IFI as defined by the European Mycoses Study Group. Results One hundred forty-four AML patients were included in the study. Ten patients received antifungal prophylaxis and none developed IFI (p=0.21). Twenty-five (17%) patients developed IFI: 2 (8%) had proven IFI, 6 (24%) probable IFI, and 17 (68%) possible IFI. Invasive pulmonary aspergillosis represented all 25 cases of proven, probable, and possible IFI. There was a statistically significant association between prolonged neutropenia ( &gt;60 days) and IFI (p=0.007), whereas age, sex, and SWOG classification were not significantly associated with IFI. Conclusion The incidence of IFI in our AML cohorts treated with ven/aza was 17%, lower than that reported at other institutions. Neutropenia &gt; 60 days was significantly associated with IFI in our AML cohort treated with ven/aza. Although we were not powered to determine whether antifungal prophylaxis impacted IFI, there was no significant difference in IFI for patients who received prophylaxis. Disclosures All Authors: No reported disclosures

Failure to achieve therapeutic levels with high-dose posaconazole tablets potentially due to enhanced clearance

2016 ◽  
Vol 24 (1) ◽  
pp. 63-66 ◽  
Author(s):  
Sam Maleki ◽  
Carmela Corallo ◽  
John Coutsouvelis ◽  
Jasmine Singh
Keyword(s):  
Acute Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Oral Absorption ◽  
Trough Level ◽  
Salvage Chemotherapy ◽  
High Dose ◽  
Pulmonary Aspergillosis ◽  
Gastrointestinal Conditions ◽  
Relapsed Acute Myeloid Leukemia ◽  
Acute Myeloid

Aim To describe a case of persistent sub-therapeutic posaconazole levels in setting of salvage chemotherapy for relapsed acute myeloid leukemia. Case details A 57-year-old male was admitted for the management of relapsed acute myeloid leukemia and ongoing pulmonary aspergillosis. While continuing on posaconazole tablet 300 mg daily, he received a course of salvage chemotherapy. The initial steady state posaconazole trough level was therapeutic at 0.84 mg/L (target >0.70 mg/L). However, after five days, the level had dropped to 0.40 mg/L, coinciding with hyperbilirubinemia and hypoalbuminemia. Bilirubin level peaked at 36 µm/L (normal high <20 µm/L), albumin levels were consistently low, averaging at 25 g/L (range 33–46 g/L). The patient had been compliant and there were no underlying gastrointestinal conditions identified which might have potentially affected posaconazole absorption. Outcome An increase in posaconazole dose failed to achieve target levels and treatment was changed to voriconazole. However, levels were surprisingly supra-therapeutic, resulting in side effects and substantial dose reduction was required. Conclusion Failure to achieve target posaconazole levels despite increased dosing may be attributed to factors other than impaired oral absorption. Enhanced metabolism and clearance could be associated with hypoalbuminemia and hyperbilirubinemia. Further case studies, including PK modelling, are required to confirm this effect.

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