Risk of reactivation of a recent invasive fungal infection in patients with hematological malignancies undergoing further intensive chemo-radiotherapy. A single-center experience and review of the literature
Martino, R.; Lopez, R.; Sureda, A.; Brunet, S.; Domingo-Albós, A.
Haematologica 82(3): 297-304
1997
ISSN/ISBN: 0390-6078 PMID: 9234575 Document Number: 477819
During January 1993-September 1996, 9 patients with a haematological malignancy and previous invasive pulmonary aspergillosis (IPA) or Pseudallescheria boydii pneumonia and 5 with invasive Candida infection received further intensive chemotherapy (n=3) or a bone marrow or peripheral blood stem cell transplant (n=11), 4 days-13 months (median 3 months) from the start of therapy for the fungal infection, at the Hospital de la Santa Creu, Barcelona, Spain. Five patients with IPA and all 5 with invasive candidosis showed complete or good partial radiological resolution of the infection with the primary antifungal therapy given, which was continued before, during and after the period(s) of subsequent neutropenia. 12 patients showed no signs of progression or reactivation of the fungal infection during therapy, while 2 patients with active IPA died with progressive Aspergillus infection shortly after an allogeneic transplant. A review of the literature revealed that in both types of infections the risk of reactivation and dissemination appeared to be low after achieving clinical and radiological signs of response, which took several weeks or months before proceeding to further antileukaemic therapy.