Summary
Disseminated fungal infection not infrequently complicates the course of allogeneic bone marrow transplantation (allo BMT) in severely immunocompromised patients, and the prognosis of BMT patients who develop systemic fungal infection is very poor. We describe a patient who developed disseminatedCandida albicans infection with liver abscess after the first allo BMT for acute myelogenous leukemia (FAB M2). The infection was successfully eradicated by the administration of miconazole and amphotericin B. However, 1 year after the first allo BMT, the patient suffered a relapse of acute myelogenous leukemia with fungal liver abscess. A second allo BMT, accelerating granulocyte recovery by recombinant human granulocyte colony-stimulating factor (rhG-CSF), was successfully performed and the fungal liver abscess resolved with a combination therapy of fluconazole and amphotericin B. The patient is alive and free of both leukemia and fungal disease more than 37 months after the first allo BMT and 25 months after the second allo BMT.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Clift RA (1984) Candidiasis in the transplant patient. Am J Med 77: 33–37
Degregorio MW, Lee WMF, Linker CA, Jacobs RA, Ries CA (1982) Fungal infections in patients with acut leukemia. Am J Med 73: 543–548
Ezaki K, Hirano M, Ohno R, Kodera Y, Ohara K, Ikeda Y, Tanaka M, Mitomo Y, Shirakawa S, Yamada K (1990) Evaluation of the prophylactic effect of oral amphotericin B on fungal infection. Acta Haematol Jpn 53: 1147–1155
Ezdinli EZ, O'Sullivan DD, Wasser LP, Kim U, Stutzman L (1979) Oral amphotericin B for candidiasis in patients with hematologic neoplasms. JAMA 242: 258–260
Fitzgerald JEJ, Coblentz C (1988) Fungal microabscesses in immuno-suppressed patients — CT appearances. J Can Assoc Radiol 39: 10–12
Krick JA, Remington JS (1976) Opportunistic invasive fungal infections in patients with leukemia and lymphoma. Clin Haematol 5: 249–310
Meunier Carpentier F (1984) Chemoprophylaxis of fungal infection. Am J Med 76: 652–656
Meyers JD, Atkinson K (1983) Infection in bone marrow transplantation. Clin Haematol 12: 791–811
Ohno R, Tomonaga M, Kobayashi T, Kanamura A, Shirakawa S, Masaoka T, Omine M, Oh H, Nomura T, Sakai Y, Hirano M, Yokomaku S, Nakayama S, Yoshida Y, Miura AB, Morishima Y, Dohy H, Niho Y, Hamajima N, Takaku F (1990) Effect of granulocyte colony-stimulating factor after intensive induction therapy in relapsed or refractory acute leukemia. N Engl J Med 323: 871–877
Robertson MJ, Larson RA (1988) Recurrent fungal pneumonias in patients with acute nonlymphocytic leukemia under-going multiple courses of intensive chemotherapy. Am J Med 84: 233–239
Robertson MJ, Socinski MA, Soiffer RJ, Finberg RW, Wilson C, Anderson KC, Bosserman L, Sang DN, Salkin IF, Ritz J (1991) Successful treatment of disseminatedFusarium infection after autologous bone marrow transplantation for acute myeloid leukemia. Bone Marrow Transplant 8: 143–145
Spinolo JA, Yau JC, Dicke KA, Scott E, Jagannath S, Horwitz LJ (1992) Second bone marrow transplants for relapsed leukemia. Cancer 69: 405–409
Tashjian LS, Abramson JS, Peacock JE (1984) Focal hepatic candidiasis: a distinct clinical variant of candidiasis in immunocompromised patients. Rev Infect Dis 6: 689–703
Tollemar J, Holmberg K, Ringden O, Loennqvist B (1989) Surveillance tests for the diagnosis of invasive fungal infections in bone marrow transplant recipients. Scand J Infect Dis 21: 205–212
Verfaillie C, Weisdorf D, Haake R, Hostetter M, Ramsay NKC, McGlave P (1991)Candida infections in bone marrow transplant recipients. Bone Marrow Transplant 8: 177–184
Wit SD, Clumeck N (1989) Fluconazole in the treatment of fungal infections associated with AIDS. Infection 17: 121–123
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Tanaka, J., Kasai, M., Masauzi, N. et al. Successful second allogeneic bone marrow transplantation in a relapsed acute myeloid leukemia patient with fungal liver abscess. Ann Hematol 65, 193–195 (1992). https://doi.org/10.1007/BF01703114
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01703114