Successful micafungin (FK463) treatment of invasive pulmonary aspergillosis in a patient with acute lymphoblastic leukemia in a phase II study.

Abstract

We treated a 52-year-old woman with acute lymphoblastic leukemia (ALL) who developed invasive pulmonary aspergillosis (IPA) as a result of neutropenia following remission-induction chemotherapy. Although serological test results, such as those for platelia and pastrex, were all negative and the serum level of beta-D-glucan was low, Aspergillus DNA was detected in blood by the polymerase chain reaction method. A clinically documented diagnosis of IPA was made on the basis of chest x-rays, computed tomography scan findings, and the detection of Aspergillus DNA. Micafungin (FK463), a candin class antifungal agent, was administered at a dose of 75 to 150 mg/day, because other antifungal agents were not effective. The increase in serum concentration of micafungin was dose-dependent and was accompanied by improvement of symptoms and objective findings. Micafungin was effective for the treatment of IPA in this patient with ALL.

• Authors: Shuichi Ota, Junji Tanaka, Kaoru Kahata, Tomomi Toubai, Keiichi Kondo, Akio Mori, Nobuyasu Toyoshima, Manabu Musashi, Masahiro Asaka, Masahiro Imamura
• Journal: International journal of hematology (Int J Hematol) Vol. 79 Issue 4 Pg. 390-3 (May 2004) ISSN: 0925-5710 [Print] Japan
• PMID: 15218972 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antineoplastic Agents
• Echinocandins
• Lipopeptides
• Lipoproteins
• Peptides, Cyclic
• Micafungin

Topics

• Antineoplastic Agents (adverse effects)
• Aspergillosis (diagnosis, drug therapy, etiology)
• Clinical Trials, Phase II as Topic
• Echinocandins
• Female
• Humans
• Lipopeptides
• Lipoproteins (pharmacokinetics, therapeutic use)
• Lung Diseases, Fungal (diagnosis, drug therapy, etiology)
• Micafungin
• Middle Aged
• Neutropenia (chemically induced, complications)
• Opportunistic Infections (diagnosis, drug therapy)
• Peptides, Cyclic (pharmacokinetics, therapeutic use)
• Precursor Cell Lymphoblastic Leukemia-Lymphoma (complications)
• Treatment Outcome