Rapid improvement of disseminated aspergillosis with caspofungin/voriconazole combination in an adult leukemic patient

Ann Hematol. 2004 Jun;83(6):390-3. doi: 10.1007/s00277-003-0792-0. Epub 2003 Dec 10.

Abstract

A 57-year-old man with acute myeloid leukemia (AML) French-American-British (FAB) 4 developed disseminated invasive cerebral and pulmonary aspergillosis during postinduction aplasia. According to international consensus, infection was categorized as probable (two host factors: deep neutropenia for >10 days and refractory fever for >96 h; major clinical criteria of lower respiratory tract and CNS invasive fungal infection; positive results for galactomannan antigen in three blood samples). After the failure of standard amphotericin-based therapy, the spectacular regression of multifocal brain and lung lesions was rapidly achieved under a caspofungin acetate/voriconazole combination. Further permanent caspofungin maintenance with voriconazole added during aplasia periods permitted two consolidation courses and autograft-based intensification without any delay.

MeSH terms

  • Antifungal Agents / administration & dosage*
  • Aspergillosis / diagnostic imaging
  • Aspergillosis / drug therapy*
  • Caspofungin
  • Drug Therapy, Combination
  • Echinocandins
  • Humans
  • Leukemia, Myelomonocytic, Acute / microbiology*
  • Lipopeptides
  • Male
  • Middle Aged
  • Peptides / administration & dosage*
  • Peptides, Cyclic*
  • Pyrimidines / administration & dosage*
  • Radiography
  • Treatment Outcome
  • Triazoles / administration & dosage*
  • Voriconazole

Substances

  • Antifungal Agents
  • Echinocandins
  • Lipopeptides
  • Peptides
  • Peptides, Cyclic
  • Pyrimidines
  • Triazoles
  • Caspofungin
  • Voriconazole