Micafungin As Antifungal Prophylaxis during Induction Phase of Chemotherapy in Pediatric Acute Lymphoblastic Leukemia

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Micafungin As Antifungal Prophylaxis during Induction Phase of Chemotherapy in Pediatric Acute Lymphoblastic LeukemiaConference abstracts

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Case Report: A 63-year-old man had been diagnosed of chronic myelomonocytic leukemia on 2015 which was asymptomatic and not treated. On 2017, he presented abruptly with skin lesions that looked like bruises but were infiltrated and affected the face and upper back. Cutaneous and bone marrow biopsy ruled out leukemia cutis and it was diagnosed of blastic plasmacytoid dendritic cell neoplasm (BPDCN). Therefore he started chemotherapy using the protocol for acute lymphoblastic leukemia ALL OLD>55 years.

Conclusion: This prospective multicenter study provides information on the current incidence and outcome of IFD in the real life setting. Practice variation between the centers may help to ultimately improve antifungal management in children at highest risk for IFDs.



Introduction
Available data on the incidence and outcome of invasive fungal diseases (IFD) in children treated for a hematological malignancy or undergoing allogeneic hematopoietic stem cell transplantation (HSCT) are mostly based on single site, retrospective studies or on studies performed prior to the availability of newer compounds such as broad-sp…

We report that the bifunctional compounds enhance the interactions between primary human neutrophils and A. fumigatus in vitro, using three microfluidic assay platforms. The bifunctional compounds significantly enhance the recruitment of neutrophils, increase hyphae killing by neutrophils in a uniform concentration of drug, and decrease hyphal tip growth velocity in the presence of neutrophils compared to the antifungal targeting moiety alone. We validated that the bifunctional compounds are also effective in vivo, using a zebrafish infection model with neutrophils expressing the appropriate EM receptor. We measured signif…

Conclusions: Although Hyper-CVAD and PE ­THEMA ALL-93 showed similar effects, Hyper-CVAD was tolerated better. Age and comorbidities should be taken into account before a chemotherapy regimen is determined for patients with ALL.Chemotherapy 2018;63:207 –213

Source: ChemotherapyCategory: Cancer & Oncology Source Type: research

Invasive fungal infections are rare in children with acute lymphoblastic leukemia. It compromises the antileukemia therapy should it happen. Central nervous system fungal infections carry high mortality. We here report the case of a 6.5-year-old girl who developed multiple central nervous system fungal abscesses possibly due to Aspergillus infection during induction therapy for acute lymphoblastic leukemia who has been successfully managed without compromising antileukemia therapy. She has been receiving antifungal therapy and maintenance chemotherapy for 20 months from diagnosis. We reviewed literature about the optimal d…

We present the case of 24-year-old patient diagnosed with Philadelphia chromosome positive acute lymphoblastic leukemia who developed right rhino-sino-orbital fungal infection with a favorable response to systemic antifungal treatment and noninvasive surgery. Later, patient refused consolidation and allogeneic hematopoietic stem cell transplant from an unrelated HLA matched donor but accepted the first generation tyrosine kinase inhibitor (Imatinib) and maintained a complete hematological and molecular response.
ABBREVIATIONS: ENT = ear nose throat; BMB = bone marrow biopsy; ALL = acute lymphoblastic leukemia; TKI = ty…

We present the case of a 3-year-old boy who was diagnosed with cerebral abscesses due to Aspergillus nidulans infection on day 28 of induction chemotherapy for acute lymphoblastic leukemia. He responded well to treatment with voriconazole and caspofungin, making a full recovery. There are very few cases of invasive aspergillosis reported in children during induction chemotherapy for acute leukemia and A. nidulans is rare in the absence of chronic granulomatous disease.

Aspergillosis is an opportunistic fungal infection that may develop in immunocompromised patients with conditions such as leukemia or aplastic anemia. A rare case of stomach perforation following acute fungal gastritis in a 13-year-old female patient with aplastic anemia is reported herein. The patient had developed aplastic anemia without bone marrow fibrosis secondary to acute lymphoblastic leukemia and chemotherapy. The pathological examination revealed a large ischemic transmural perforation (9.5 × 9 cm) associated with fungal septic emboli. Fungal hyphae characteristics were compatible with those of Aspergillus …

Conclusions: An increasing trend in incidence of IA was observed during the latter half of study period. Early empiric therapy led to modest aspergillus-free survival. Clinical and financial implications of IA mandate review of institutional antifungal prophylaxis policy especially in selected ALL patients during induction.

Invasive fungal infections in children with acute lymphoblastic leukemia have been a major cause of mortality. Recent reports have described increasing incidence of invasive non-Aspergillus mold infections in patients with hematological malignancies. It is always challenging to treat invasive fungal infection and underlying hematological malignancies successfully. Here we report a girl with high-risk acute lymphoblastic leukemia who developed disseminated Cunninghamella bertholletiae infection during induction chemotherapy.

Source: Pediatrics and NeonatologyCategory: Perinatology & Neonatology Authors: Tags: Case report Source Type: research



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