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International Journal of Hematology

, Volume 79, Issue 4, pp 390–393 | Cite as

Successful Micafungin (FK463) Treatment of Invasive Pulmonary Aspergillosis in a Patient with Acute Lymphoblastic Leukemia in a Phase II Study

  • Shuichi Ota
  • Junji Tanaka
  • Kaoru Kahata
  • Tomomi Toubai
  • Keiichi Kondo
  • Akio Mori
  • Nobuyasu Toyoshima
  • Manabu Musashi
  • Masahiro Asaka
  • Masahiro Imamura
Case Report

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 β-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 ofAspergillus DNA. Micafungin (FK463), a candin class anti-fungal 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.

Key words

Invasive pulmonary aspergillosis Micafungin (FK463) Candin Acute lymphoblastic leukemia Aspergillus DNA 

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References

  1. 1.
    Denning DW. Therapeutic outcome in invasive aspergillosis.Clin Infect Dis. 1996;23:608–615.CrossRefGoogle Scholar
  2. 2.
    Schwartz S, Behre G, Heinemann V, et al. Aerosolized amphotericin B inhalations as prophylaxis of invasive aspergillus infections during prolonged neutropenia: results of a prospective randomized multicenter trial.Blood. 1999;93:3654–3661.Google Scholar
  3. 3.
    Perea S, Patterson TF. InvasiveAspergillus infections in hematologic malignancy patients.Semin Respir Infect. 2002;17:99–105.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Jantunen E, Anttila VJ, Ruutu T.Aspergillus infections in allogeneic stem cell transplant recipients: have we made any progress?Bone Marrow Transplant. 2002;30:925–929.CrossRefPubMedGoogle Scholar
  5. 5.
    Denning DW. Echinocandin antifungal drugs.Lancet. 2003;362:1142–1151.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Mikamo H, Sato Y, Tamaya T.In vitro antifungal activity of FK463, a new water-soluble echinocandin-like lipopeptide.J Antimicrob Chemother. 2000;46:485–487.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Tawara S, Ikeda F, Maki K, et al.In vitro activities of a new lipopeptide antifungal agent, FK463, against a variety of clinically important fungi.Antimicrob Agents Chemother. 2000;44:57–62.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Uchida K, Nishiyama Y, Yokota N, Yamaguchi H.In vitro antifungal activity of a novel lipopeptide antifungal agent, FK463, against various fungal pathogens.J Antibiot (Tokyo). 2000;53:1175–1181.CrossRefGoogle Scholar
  9. 9.
    Petraitis V, Petraitiene R, Groll AH, et al. Comparative antifungal activities and plasma pharmacokinetics of micafungin (FK463) against disseminated candidiasis and invasive pulmonary aspergillosis in persistently neutropenic rabbits.Antimicrob Agents Chemother. 2002;46:1857–1869.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Ikeda F, Wakai Y, Matsumoto S, et al. Efficacy of FK463, a new lipopeptide antifungal agent, in mouse models of disseminated candidiasis and aspergillosis.Antimicrob Agents Chemother. 2000; 44:614–618.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Matsumoto S, Wakai Y, Nakai T, et al. Efficacy of FK463, a new lipopeptide antifungal agent, in mouse models of pulmonary aspergillosis.Antimicrob Agents Chemother. 2000;44:619–621.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Makimura K, Murayama SY, Yamaguchi H. Detection of a wide range of medically important fungi by the polymerase chain reaction.J Med Microbiol. 1994;40:358–364.CrossRefPubMedGoogle Scholar
  13. 13.
    Caillot D, Couaillier JF, Bernard A, et al. Increasing volume and changing characteristics of invasive pulmonary aspergillosis on sequential thoracic computed tomography scans in patients with neutropenia.J Clin Oncol. 2001;19:253–259.CrossRefPubMedGoogle Scholar
  14. 14.
    Verweij PE, Stynen D, Rijs AJ, de Pauw BE, Hoogkamp-Korstanje JA, Meis JF. Sandwich enzyme-linked immunosorbent assay compared with Pastorex latex agglutination test for diagnosing invasive aspergillosis in immunocompromised patients.J Clin Microbiol. 1995;33:1912–1914.PubMedPubMedCentralGoogle Scholar
  15. 15.
    Buchheidt D, Baust C, Skladny H, et al. Detection of Aspergillus species in blood and bronchoalveolar lavage samples from immunocompromised patients by means of 2-step polymerase chain reaction: clinical results.Clin Infect Dis. 2001;33:428–435.CrossRefPubMedGoogle Scholar
  16. 16.
    Azuma J, Nakahara K, Kagayama A, Okuma T, Kawamura A, Mukai T. Pharmacokinetic study of micafungin.J Infect Chemother. 2002;50:155–185.Google Scholar
  17. 17.
    Kaneko H, Yamato Y, Hashimoto T, et al. Drug interactions of micafunginin vitro. J Infect Chemother. 2002;50:94–103.Google Scholar

Copyright information

© The Japanese Society of Hematology 2004

Authors and Affiliations

  • Shuichi Ota
    • 1
  • Junji Tanaka
    • 2
  • Kaoru Kahata
    • 1
  • Tomomi Toubai
    • 2
  • Keiichi Kondo
    • 1
  • Akio Mori
    • 1
  • Nobuyasu Toyoshima
    • 1
  • Manabu Musashi
    • 3
  • Masahiro Asaka
    • 1
  • Masahiro Imamura
    • 2
  1. 1.Departments of Internal Medicine, Gastroenterology & Hematology SectionHokkaido University Graduate School of MedicineSapporoJapan
  2. 2.Internal Medicine, Hematology & Oncology SectionHokkaido University Graduate School of MedicineJapan
  3. 3.Health Administration CenterHokkaido UniversitySapporoJapan

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