Epileptic seizures and rhinocerebral mucormycosis during blinatumomab treatment in a patient with biphenotypic acute leukemia

Vogt, Niklas; Heß, Katharina; Bialek, Ralf; Buerke, Boris; Brüggemann, Monika; Topp, Max S.; Groth, Christoph; Berdel, Wolfgang E.; Lenz, Georg; Stelljes, Matthias

doi:10.1007/s00277-016-2837-1

Cited by 12 publications

(9 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We did not use blinatumomab in any of these patients, but have used it successfully in patients with other invasive infections. There are several case reports of mucormycosis developing in children receiving blinatumomab, but there is no literature describing the use of this agent as bridging chemotherapy in patients with mucormycosis.…”

Section: Discussionmentioning

confidence: 99%

Mucormycosis diagnosed during induction chemotherapy in five pediatric patients with acute lymphoblastic leukemia

Aftandilian

Eguiguren

Mathew

et al. 2019

Pediatric Blood & Cancer

View full text Add to dashboard Cite

Mucormycosis in pediatric oncology patients is a rare invasive fungal infection associated with significant morbidity and mortality. We describe five patients diagnosed with mucormycosis during induction chemotherapy for acute lymphoblastic leukemia at our institution. All of the patients in our series survived, some in spite of having disseminated disease. Most of the patients’ chemotherapy was modified with the aim of controlling their leukemia while minimizing immunosuppression until their fungal infection was under control. Although mucormycosis is frequently fatal, rapid diagnosis and a multidisciplinary approach can lead to excellent outcomes, even in patients undergoing intensive chemotherapy.

show abstract

Section: Discussionmentioning

confidence: 99%

Mucormycosis diagnosed during induction chemotherapy in five pediatric patients with acute lymphoblastic leukemia

Aftandilian

Eguiguren

Mathew

et al. 2019

Pediatric Blood & Cancer

View full text Add to dashboard Cite

show abstract

“…Brain involvement is associated with a high mortality. 164 Of note, in a French study, Rhizopus oryzae was implicated in 85% of ROCM compared with only 17% of nonrhinocerebral forms of mucormycosis (p < 0.001). 70 Rapid and aggressive treatment with combined surgical debridement/resection and medical therapy is essential for a successful outcome from ROCM.…”

Section: Rhino-orbital-cerebral Mucormycosismentioning

confidence: 91%

Mucormycosis

Reid

Lynch

Fishbein

et al. 2020

Semin Respir Crit Care Med

149

108

View full text Add to dashboard Cite

Mucormycosis is an infection caused by a group of filamentous molds within the order Mucorales. Infections may result from ingestion of contaminated food, inhalation of spores into the nares or lungs, or inoculation into disrupted skin or wounds. In developed countries, mucormycosis occurs primarily in severely immunocompromised hosts (e.g., those with hematological malignancies, organ transplantation, neutropenia, autoimmune disorders, or other impairments in immunity). Only 6 to 10% of cases occur in subjects with no underlying disease. In contrast, in developing countries, most cases of mucormycosis occur in persons with poorly controlled diabetes mellitus or in immunocompetent subjects following trauma. Mucormycosis exhibits a marked propensity to invade blood vessels, leading to thrombosis, necrosis, and infarction of tissue. Mortality associated with invasive mucormycosis is high (> 30–50%), with 90% mortality associated with disseminated disease. Mortality rates are much lower, though still significant (10–30%), among patients with localized cutaneous disease.The diagnosis of mucormycosis relies upon histopathology and culture. Blood tests are of limited diagnostic value. Even with disseminated disease, blood cultures are usually negative. Mucorales have a distinct histological appearance, with irregular, nonseptate hyphae that branch at right angles. Cultures and/or polymerase chain reaction (PCR) are important to identify the genera.Based on anatomic localization, mucormycosis can be classified as one of six forms: (1) rhino-orbital-cerebral mucormycosis (ROCM), (2) pulmonary, (3) cutaneous, (4) gastrointestinal (GI), (5) disseminated, and (6) mucormycosis of uncommon sites. Among diabetics, ROCM is the most common clinical presentation, whereas lung involvement is uncommon. In contrast, among organ transplant recipients or patients with hematological malignancies (HemeM), pulmonary and disseminated diseases are most common. Mucormycosis can progress rapidly, and delay in initiation of treatment by even a few days markedly worsens outcomes.Due to the rarity of mucormycosis, randomized controlled therapeutic trials have not been performed. Lipid formulations of amphotericin B (LFAB) are the mainstay of therapy, but the newer triazoles, posaconazole (POSA) and isavuconazole (ISAV) (the active component of the prodrug isavuconazonium sulfate), may be effective in patients refractory to or intolerant of LFAB. Early surgical debridement or excision plays an important adjunctive role. Additional studies are required to assess the optimal duration of therapy as well as the specific roles of LFAB and the triazoles in the treatment of mucormycosis.

show abstract

“…Brain involvement is associated with a high mortality. 186 Interestingly, in a French study of mucormycosis, Rhizopus oryzae was implicated in 85% of ROCM compared with only 17% of nonrhinocerebral forms (p < 0.001). 127 Rapid and aggressive treatment with combined surgical debridement/resection and medical therapy is essential for successful outcome of ROCM.…”

Section: Rhino-orbital-cerebral Involvementmentioning

confidence: 94%

Fungal Infections Complicating Lung Transplantation

Clark

Weigt

Fishbein³

et al. 2018

Semin Respir Crit Care Med

View full text Add to dashboard Cite

Lung transplantation is an increasingly utilized modality for treating advanced lung disease. However, lung transplant recipients (LTRs) experience high rates of infection-related mortality and, compared with other solid organ transplant recipients, are at increased risk of infectious complications given the intensity of immunosuppression employed, the presence of airway abnormalities after surgery and exposure of the allograft to the environment. Fungal infections, particularly mold infections, are problematic after transplantation as they are often associated with limited treatment options and poor outcomes. We describe the non- fungal infections occurring in LTRs, including their epidemiology, clinical features, and treatment.

show abstract

Epileptic seizures and rhinocerebral mucormycosis during blinatumomab treatment in a patient with biphenotypic acute leukemia

Cited by 12 publications

References 11 publications

Mucormycosis diagnosed during induction chemotherapy in five pediatric patients with acute lymphoblastic leukemia

Mucormycosis diagnosed during induction chemotherapy in five pediatric patients with acute lymphoblastic leukemia

Mucormycosis

Fungal Infections Complicating Lung Transplantation

Contact Info

Product

Resources

About