scholarly journals Invasive Fungal Infection Caused by Geotrichum clavatum in a Child with Acute Leukemia: First Documented Case from Mainland China

2019 ◽  
Vol 72 (2) ◽  
pp. 130-132 ◽  
Author(s):  
Xingxin Liu ◽  
Wei Zhou ◽  
Yongmei Jiang ◽  
Linghan Kuang
Keyword(s):  
Acute Leukemia ◽  
Fungal Infection ◽  
Invasive Fungal Infection ◽  
Mainland China ◽  
Documented Case

scholarly journals Successful treatment of gastrointestinal mucormycosis in an adult with acute leukemia: case report and literature review

2017 ◽  
Vol 24 (1) ◽  
pp. 61 ◽  
Author(s):  
A. Alghamdi ◽  
A. Lutynski ◽  
M. Minden ◽  
C. Rotstein
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Acute Leukemia ◽  
Fungal Infection ◽  
Antifungal Therapy ◽  
Successful Treatment ◽  
Invasive Fungal Infection ◽  
Hematologic Malignancies ◽  
Considerable Morbidity ◽  
Delays In Diagnosis

Mucormycosis has emerged as an important cause of invasive fungal infection in patients with hematologic malignancies. Gastrointestinal mucormycosis is an unusual presentation of this invasive fungal infection, and it causes considerable morbidity and mortality. Such outcomes are due in part to a nonspecific presentation that results in delays in diagnosis and treatment. Successful treatment of gastrointestinal mucormycosis involves surgical debridement and appropriate antifungal therapy.

scholarly journals Mucormycosis of the paranasal sinuses in a patient with acute myeloid leukemia

2016 ◽  
Vol 144 (11-12) ◽  
pp. 657-660
Author(s):  
Natasa Colovic ◽  
Valentina Arsic-Arsenijevic ◽  
Aleksandra Barac ◽  
Nada Suvajdzic ◽  
Danijela Lekovic ◽  
...  
Keyword(s):  
Febrile Neutropenia ◽  
Acute Leukemia ◽  
Fungal Infection ◽  
Invasive Fungal Infection ◽  
Paranasal Sinuses ◽  
Rhizopus Oryzae ◽  
Non Invasive ◽  
Specimen Processing ◽  
The Face ◽  
The Right

Introduction. Invasive fungal infection is among the leading causes of morbidity, mortality, and economic burden for patients with acute leukemia after induction of chemotherapy. In the past few decades, the incidence of invasive fungal infection has increased dramatically. Its management has been further complicated by the increasing frequency of infection by non-Aspergillus molds (e.g. Mucorales). Neutropenic patients are at a high risk of developing an invasive mucormycosis with fulminant course and high mortality rate (35-100%). Case Outline. We are presenting the case of a 72-year-old male with an acute monoblastic leukemia. The patient was treated during five days with hydroxycarbamide 2 ? 500 mg/day, followed by cytarabine 2 ? 20 mg/sc over the next 10 days. He developed febrile neutropenia, headache, and edema of the right orbital region of the face. Computed tomography of the sinuses revealed shadow in sinuses with thickening of mucosa of the right paranasal sinuses. Lavage and aspirate from the sinuses revealed Rhizopus oryzae. Mucormycosis was successfully treated with amphotericin B (5 mg/kg/day) followed by ketoconazole (400 mg/day). Two months later the patient died from primary disease. Conclusion. In patients with acute leukemia who developed aplasia, febrile neutropenia, and pain in paranasal sinuses, fungal infection should be taken into consideration. New and non-invasive methods for taking samples from sinuses should be standardized in order to establish an early and accurate diagnosis of mucormycosis with the source in paranasal sinuses, and to start early treatment by a proper antifungal drug. Clear communication between physician and mycologist is critical to ensure proper and timely sampling of lavage and aspirate from sinuses and correct specimen processing when mucormycosis is suspected clinically.

scholarly journals Prevention of Invasive Fungal Infection during Chemotherapy-Induced Neutropenia in Patients with Acute Leukemia

1994 ◽  
Vol 68 (3) ◽  
pp. 327-331 ◽  
Author(s):  
Hideki AKIYAMA ◽  
Shinichiro MORI ◽  
Shu TANIKAWA ◽  
Hisashi SAKAMAKI ◽  
Yasusuke ONOZAWA
Keyword(s):  
Acute Leukemia ◽  
Fungal Infection ◽  
Invasive Fungal Infection ◽  
Chemotherapy Induced Neutropenia

Invasive Fungal Infection in Acute Leukemia Patients: What Is Their Impact on the Chemotherapy Schedule?.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 4355-4355
Author(s):  
Caroline Even ◽  
Cecile Pautas ◽  
Yosr Hicheri ◽  
Sebastien Maury ◽  
Mathieu Kuentz ◽  
...  
Keyword(s):  
At Risk ◽  
Acute Leukemia ◽  
Fungal Infection ◽  
Invasive Fungal Infection ◽  
Lymphoblastic Leukemia ◽  
Secondary Prophylaxis ◽  
First Episode ◽  
Induction Phase ◽  
Number Of Patients ◽  
The Impact

Abstract Invasive fungal infection (IFI) occurs in 2–12% of acute leukemia patients, with different prevalences according to centers, and phases of treatment. The mortality rates of the main IFI (i.e., aspergillosis and candidiasis) are well illustrated in the literature, as well as the risk of fungal relapse during subsequent periods at risk, such as a new neutropenic phase, or transplant. However, few data are available about the impact of IFI on the subsequent chemotherapy schedule. Clinicians are usually reluctant to give the full chemotherapy doses on time, due to the risk of life-threatening fungal relapse during the subsequent courses. Even with secondary prophylaxis which is now widely given, they usually delay or decrease the doses of chemotherapy. This may impact on the leukemia outcome. Objective: The aim of this single-institution retrospective study was to look at the impact of proven or probable IFI onset on the application of the chemotherapy schedule as planned in the initial strategy in patients with acute leukemia. Delays, and changes in chemotherapy doses and drug choices were evaluated and compared to the planned schedule in the protocole. Methods: All consecutive acute leukemia patients with a first episode of proven or probable IFI according to the EORTC-MSG criteria between 2000–2006 were reviewed. All patients have been treated in, or according to, clinical research protocols where timing and doses of chemotherapy were predefined. Patients who were planned for allogeneic transplant were excluded as those who were at their last consolidation course when they got IFI. Any delay, dose decrease or dose change were defined as any difference compared to the planned schedule. Results: 28 patients (7 candidiasis, 20 aspergillosis, 1 zygomycosis) were included (M/F: 15/13; mean age: 54y), including 27 acute myeloid leukemia and one acute lymphoblastic leukemia. Eleven (39%) were proven, 17 (61%) were probable. Twenty (71%) of these IFI occurred during the first induction phase. All patients were treated for their IFI with ≥ 1 antifungal, and 4 of them had a surgical resection of the main fungal lesion (s). Seventeen of 28 (60%) had their next course delayed (median delay: 14 days) when compared to the planned protocole. The doses of the antineoplastic drug(s) were modified in 7 (25%) patients. Only 9 (32%) patients got their next chemotherapy course without any modification in time, dose, or choice of drug. Although the number of patients in our study does not allow definite conclusions, these changes should have an impact on leukemia-free and overall survivals. Conclusion: Due to the risk of fungal relapse during a subsequent period at risk, IFI has a practical impact on the dates, doses, and choices of chemotherapy in acute leukemia in more than two thirds of the patients, due to subjective decisions of the clinicians. Effective antifungal strategies are needed to avoid the onset of IFI in acute leukemia patients.

Voriconazole prophylaxis in leukemic patients: A retrospective single-center study

2019 ◽  
Vol 26 (4) ◽  
pp. 873-881
Author(s):  
Vivian Bui ◽  
Sandra AN Walker ◽  
Marion Elligsen ◽  
Anju Vyas ◽  
Alex Kiss ◽  
...  
Keyword(s):  
Acute Leukemia ◽  
Fungal Infection ◽  
Invasive Fungal Infection ◽  
Fungal Infections ◽  
Lymphoblastic Leukemia ◽  
Retrospective Chart Review ◽  
Liver Function Tests ◽  
Antifungal Prophylaxis ◽  
Invasive Fungal Infections ◽  
Acute Myeloid

Background Invasive fungal infections commonly occur in acute myeloid and lymphoblastic leukemia patients receiving chemotherapy. In these patients with acute leukemia, posaconazole prophylaxis is recommended; however, voriconazole may be a less costly alternative. Objectives The objective of this study was to evaluate the efficacy and safety of voriconazole prophylaxis in acute leukemia patients. Methods A retrospective chart review of inpatients at Sunnybrook Health Sciences Centre between 2005 and 2017 was completed. Hospitalized adult acute leukemia patients who received voriconazole prophylaxis (cases) were compared to patients who received fluconazole or no prophylaxis during chemotherapy (controls). Statistical analyses comparing baseline characteristics, safety, and efficacy outcomes between the study cohorts were completed. A posaconazole literature-based weighted mean risk was compared to the voriconazole risk of invasive fungal infection identified in this study. Results Of 490 acute myeloid leukemia or acute lymphoblastic leukemia patients, 83 controls and 92 cases were eligible. Case patients received an average of 24.4 ± 10.8 days of voriconazole prophylaxis. The incidence of proven or probable invasive fungal infections with voriconazole was 3.3% (3/92) versus 7.2% (6/83) in the control cohort (p > 0.05) and was comparable to the literature reported weighted incidence of invasive fungal infection with posaconazole (2.4 ± 2.1%; 95% CI 1.3%–3.4%; p > 0.05). Voriconazole was well tolerated by patients (91%; 84/91; seven discontinued due to asymptomatic elevated liver function tests). Conclusions Voriconazole prophylaxis was found to be safe, effective, and comparable to literature-based efficacy data for risk of invasive fungal infection with posaconazole antifungal prophylaxis in patients with acute leukemia undergoing chemotherapy and could represent a significant cost advantage.

scholarly journals Voriconazole plus caspofungin for treatment of invasive fungal infection in children with acute leukemia

2017 ◽  
Vol 52 (3) ◽  
pp. 167 ◽  
Author(s):  
Kyu Ho Lee ◽  
Young Tae Lim ◽  
Jeong Ok Hah ◽  
Yu Kyung Kim ◽  
Chae Hoon Lee ◽  
...  
Keyword(s):  
Acute Leukemia ◽  
Fungal Infection ◽  
Invasive Fungal Infection

scholarly journals INVASIVE FUNGAL INFECTION IN CHILDREN WITH ACUTE LEUKEMIA AND SEVERE APLASTIC ANEMIA

2021 ◽  
Vol 13 (1) ◽  
pp. e2021039
Author(s):  
Sutatta Supatharawanich ◽  
Nattee Narkbunnam ◽  
Nassawee Vathana ◽  
Chayamon Takpradit ◽  
Kamon Phuakpet ◽  
...  
Keyword(s):  
Acute Leukemia ◽  
Fungal Infection ◽  
Aplastic Anemia ◽  
Invasive Fungal Infection ◽  
Odds Ratio ◽  
Childhood Leukemia ◽  
Multivariable Analysis ◽  
Case Fatality ◽  
Infectious Complications ◽  
Severe Aplastic Anemia

Although the outcome of childhood leukemia and severe aplastic anemia (SAA) has improved, infectious complications are still the major concern, particularly invasive fungal infection (IFI), which is one of the most common causes of infectious related death in such patients with prolonged neutropenia.  A retrospective study of IFI in pediatric patients with newly diagnosed and relapsed acute leukemia and SAA in Siriraj Hospital, Mahidol University, Thailand, was conducted.   There were 241 patients (150 patients with ALL, 35 patients with AML, 31 patients with relapsed leukemia and 25 patients with SAA) with the median age of 5.4 years (rage, 0.3-16.0 years). The overall prevalence of IFI was 23.2%, and the breakdown prevalence in ALL, AML, relapsed leukemia and SAA were 12.7%, 37.1%, 45.2% and 40.0% respectively. Candida tropicalis was the most common identifiable organism. Pulmonary IFI caused by invasive aspergillosis was the most common site of infection. The overall case-fatality rate was 50.0% with the highest rate in relapsed leukemia of 92.9%. In multivariable analysis, the age > 4 years, AML, relapsed leukemia and SAA were found to be independent risk factors of IFI with adjusted odds ratio of 2.3, 4.1, 5.1 and 3.7 respectively. In SAA group, only very severe aplastic anemia (ANC < 200 mm3) was found to be associated with development of IFI with odds ratio of 32.7. IFI in Thai children with hematologic diseases appeared to be prevalent with high fatality. Anti-fungal prophylaxis should be considered in patients with SAA to prevent IFI.

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