Authors: M Eibl H W Auner W ZinkeCerwenka H Sill H J Dornbusch W Linkesch
Publish Date: 2003/10/03
Volume: 83, Issue: 2, Pages: 133-136
Abstract
Acute myeloid leukemia AML associated with central diabetes insipidus DI and chromosomal aberrations is characterised by a very poor prognosis We present a 28yearold female with AML FAB M0 preceding DI and cytogenetic abnormalities monosomy 7 and inversion of chromosome 9 Complete remission was achieved with FLAG after she was refractory to two different induction regimens Prolonged neutropenia resulted in invasive pulmonary aspergillosis Allogeneic stem cell transplantation from a matched unrelated donor was performed using a reducedintensity conditioning regimen Desmopressin substitution for DI was withdrawn after transplant without recurrence of symptoms Initial antifungal treatment including liposomal amphotericin B caspofungin and itraconazole was replaced by voriconazole after deterioration of pulmonary aspergillosis resulting in improvement stabilisation and finally also as the combined effect of discontinuation of the immunosuppressive therapy in disappearance of signs and symptoms Thirteen months after transplant the patient is in continuous complete remission The presented case study thus demonstrates that highrisk AML with concomitant invasive fungal infection may be safely and effectively treated by nonmyeloablative stem cell transplantation and longterm administration of voriconazole
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