Voriconazole in the management of invasive aspergillosis in two patients with acute myeloid leukemia undergoing stem cell transplantation

Mattei, Daniele; Mordini, Nicola; Nigro, Cristiana Lo; Ghirardo, Donatella; Ferrua, Mt; Osenda, M; Gallamini, Andrea; Bacigalupo, Andrea; Viscoli, Claudio

doi:10.1038/sj.bmt.1703763

Cited by 18 publications

(15 citation statements)

References 18 publications

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“…Voriconazole Efficacy of voriconazole (VRC) against IA was first demonstrated in some reports, including after the use of AmB-d, lipid formulation of amphotericin B deoxycholate, or itraconazole [32,[147][148][149]. These results were confirmed in a recent study that reported the superiority of VRC (two i.v.…”

Section: New Drugssupporting

confidence: 78%

Invasive pulmonary aspergillosis in patients with chronic obstructive pulmonary disease

Bulpa¹,

Dive²,

Sibille³

2007

European Respiratory Journal

304

200

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Aspergillus spp. cultured in specimens from the airways of chronic obstructive pulmonary disease (COPD) patients are frequently considered as a contaminant. However, growing evidence suggests that severe COPD patients are at higher risk of developing invasive pulmonary aspergillosis (IPA), although IPA incidence in this population is poorly documented. Some data report that COPD is the underlying disease in 1% of patients with IPA.Definitive diagnosis of IPA in COPD patients is often difficult as tissue samples are rarely obtained before death. Diagnosis is therefore usually based on a combination of clinical features, radiological findings (mostly thoracic computed tomography scans), microbiological results and, sometimes, serological information.Of 56 patients with IPA reported in the literature, 43 (77%) were receiving corticosteroids on admission to hospital. Breathlessness was always a feature of disease and excess wheezing was present in 79% of patients. Fever (.38uC) was present in only 38.5%. Chest pain and haemoptysis were uncommon. Six out of 33 (18%) patients had tracheobronchitis observed during bronchoscopy. The median delay between symptoms and diagnosis was 8.5 days. The mortality rate was high: 53 out of 56 (95%) patients died despite invasive ventilation and antifungal treatment in 43 (77%) of them.In chronic obstructive pulmonary disease patients, invasive pulmonary aspergillosis currently carries a very poor prognosis. Outcome could perhaps be improved by more rapid diagnosis and prompt therapy with voriconazole.

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Section: New Drugssupporting

confidence: 78%

Invasive pulmonary aspergillosis in patients with chronic obstructive pulmonary disease

Bulpa¹,

Dive²,

Sibille³

2007

European Respiratory Journal

304

200

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“…In a number of small analyses of the use of voriconazole in transplant recipients, the outcome has been similar to that observed in the randomized trial described above (19,72,173,194). In a large series of patients with central nervous system aspergillosis treated with voriconazole, the survival rate was 15% for those with hematologic malignancy, 21% for the HSCT recipients, and 33 to 67% for others, which included organ transplant recipients (317).…”

Section: Therapy Of Invasive Aspergillosismentioning

confidence: 76%

AspergillusInfections in Transplant Recipients

2005

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Aspergillus infections are occurring with an increasing frequency in transplant recipients. Notable changes in the epidemiologic characteristics of this infection have occurred; these include a change in risk factors and later onset of infection. Management of invasive aspergillosis continues to be challenging, and the mortality rate, despite the use of newer antifungal agents, remains unacceptably high. Performing molecular studies to discern new targets for antifungal activity, identifying signaling pathways that may be amenable to immunologic interventions, assessing combination regimens of antifungal agents or combining antifungal agents with modulation of the host defense mechanisms, and devising diagnostic assays that can rapidly and reliably diagnose infections represent areas for future investigations that may lead to further improvement in outcomes

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“…Due to its excellent penetration into inflamed and normal tissues, voriconazole is successfully used in the management of patients with severe disseminated fungal infections [21,22,29,33]. Encouraging results have been obtained with voriconazole in therapy of fungal meningitis and cerebral abscesses unamenable to treatment with amphotericin B or other antifungal agents [21,29,33].…”

Section: Discussionmentioning

confidence: 98%

Histological examination of an eye with endogenous Aspergillus endophthalmitis treated with oral voriconazole: a case report

Aliyeva¹,

Ullmann

Kottler³

et al. 2004

Graefe's Arch Clin Exp Ophthalmol

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Endogenous Aspergillus endophthalmitis is a devastating condition often associated with immunodeficiency. The pathogenesis of this entity implies the primary invasion of choroidal and retinal vessels. The lack of antifungal drugs with high blood-ocular permeability results in an extremely poor visual prognosis. Our histological examination indicates promising activity and ocular penetration of the new antifungal agent voriconazole.

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Voriconazole in the management of invasive aspergillosis in two patients with acute myeloid leukemia undergoing stem cell transplantation

Cited by 18 publications

References 18 publications

Invasive pulmonary aspergillosis in patients with chronic obstructive pulmonary disease

Invasive pulmonary aspergillosis in patients with chronic obstructive pulmonary disease

AspergillusInfections in Transplant Recipients

Histological examination of an eye with endogenous Aspergillus endophthalmitis treated with oral voriconazole: a case report

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