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Secondary prophylaxis of invasive fungal infections with combination antifungal therapy and G-CSF-mobilized granulocyte transfusions in three children with hematological malignancies

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Abstract

Fungal infections represent a life-threatening complication for patients receiving chemotherapy or undergoing hematopoietic stem cell transplantation. Historically, antifungal monotherapy is associated with a poor outcome. We treated three children with hematological malignancies and proven fungal infections (one cerebral mold infection, one disseminated Candida infection, one naso-pharyngeal mucor infection) with combination antifungal therapy plus granulocyte-colony-stimulation-factor-mobilized granulocyte transfusions as secondary prophylaxis during subsequent neutropenic episodes. With this approach, the fungal infection was effectively treated, and the anticancer therapy was completed without major delay. All children survived the fungal infection and the underlying malignancy. These experiences illustrate the feasibility of this approach using more than one antifungal agent together with immune-therapy in high-risk patients.

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Authors and Affiliations

  1. Department of Paediatric Haematology and Oncology, Medizinische Hochschule Hannover, OE 6780, Carl-Neuberg Str. 1, D-30625, Hannover, Germany

    Lorenz Grigull, Andreas Beilken, Hansjoerg Schmid, Karl-Walter Sykora, Christin Linderkamp & Karl Welte

  2. Department of Clinical Microbiology, Medizinische Hochschule Hannover, Carl-Neuberg Str. 1, D-30625, Hannover, Germany

    P. Kirschner

  3. Department of Neuroradiology, Medizinische Hochschule Hannover, Carl-Neuberg Str. 1, D-30625, Hannover, Germany

    Frank Donnerstag

  4. Department of Transfusion Medicine, Medizinische Hochschule Hannover, Carl-Neuberg Str. 1, D-30625, Hannover, Germany

    Lilia Goudeva & Hans-Gert Heuft

Authors
  1. Lorenz Grigull
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  2. Andreas Beilken
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  3. Hansjoerg Schmid
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  4. P. Kirschner
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  5. Karl-Walter Sykora
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  6. Christin Linderkamp
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  7. Frank Donnerstag
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  8. Lilia Goudeva
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  9. Hans-Gert Heuft
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  10. Karl Welte
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Corresponding author

Correspondence to Lorenz Grigull.

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Grigull, L., Beilken, A., Schmid, H. et al. Secondary prophylaxis of invasive fungal infections with combination antifungal therapy and G-CSF-mobilized granulocyte transfusions in three children with hematological malignancies. Support Care Cancer 14, 783–786 (2006). https://doi.org/10.1007/s00520-005-0910-8

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  • DOI: https://doi.org/10.1007/s00520-005-0910-8

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