scholarly journals Isavuconazole in the Treatment of Coccidioidal Meningitis

2018 ◽  
Vol 63 (3) ◽  
Author(s):  
Arash Heidari ◽  
Miriam Quinlan ◽  
David J. Benjamin ◽  
Brett Laurence ◽  
Anandit Mu ◽  
...  
Keyword(s):  
Antifungal Therapy ◽  
Stable Disease ◽  
Retrospective Review ◽  
Salvage Therapy ◽  
Successful Therapy ◽  
Cumulative Toxicity ◽  
Antifungal Efficacy

ABSTRACT Patients with coccidioidal meningitis require lifelong antifungal therapy. Cumulative toxicity and lack of antifungal efficacy require salvage therapy in the treatment of some patients. In a retrospective review of nine patients with coccidioidal meningitis treated with isavuconazole, successful therapy was seen in three patients and stable disease was confirmed in six patients. Isavuconazole may be a useful addition to the therapeutic choices currently available for coccidioidal meningitis.

Salvage therapy with voriconazole for invasive fungal infections in patients failing or intolerant to standard antifungal therapy

2003 ◽  
Vol 76 (11) ◽  
pp. 1632-1637 ◽  
Author(s):  
L. R. Baden ◽  
J. T. Katz ◽  
J. A. Fishman ◽  
C. Koziol ◽  
A. DelVecchio ◽  
...  
Keyword(s):  
Antifungal Therapy ◽  
Salvage Therapy ◽  
Fungal Infections ◽  
Invasive Fungal Infections

Salvage Therapy of Open, Infected Surgical Wounds: A Retrospective Review Using Techni-Care®

2000 ◽  
Vol 1 (2) ◽  
pp. 109-114 ◽  
Author(s):  
Brian C. Grubbs ◽  
Catherine L. Statz ◽  
Eric M. Johnson ◽  
Marc E. Uknis ◽  
James T. Lee ◽  
...  
Keyword(s):  
Retrospective Review ◽  
Salvage Therapy ◽  
Surgical Wounds

scholarly journals Use of Nebulized Amphotericin B in the Treatment of Allergic Bronchopulmonary Aspergillosis in Cystic Fibrosis

2010 ◽  
Vol 2010 ◽  
pp. 1-9 ◽  
Author(s):  
M. Proesmans ◽  
F. Vermeulen ◽  
M. Vreys ◽  
K. De Boeck
Keyword(s):  
Cystic Fibrosis ◽  
Amphotericin B ◽  
Antifungal Therapy ◽  
Allergic Bronchopulmonary Aspergillosis ◽  
Lung Infection ◽  
Steroid Withdrawal ◽  
Successful Therapy ◽  
Lipid Complex ◽  
Safety And Efficacy ◽  
Systemic Corticosteroids

Background. Systemic steroids and adjunctive antifungal therapy are the cornerstone in treating allergic bronchopulmonary aspergillosis (ABPA) in the context of CF.Aim. Evaluate the use of inhaled amphotericin B (iAMB) as antifungal agent in this context.Methods. Report of 7 CF patients with recurrent or difficult to treat ABPA and failure to taper systemic corticosteroids treated with AMB deoxycholate (AMB-d) (Fungizone 25 mg 3× a week) or AMB lipid complex (ABLC) (Abelcet 50 mg twice weekly). Successful therapy was defined as steroid withdrawal without ABPA relapse within 12 months.Results. Therapy was successful in 6 of 7 patients treated with iAMB. In 5/6, lung function improved. The patient with treatment failure has concomitant MAC lung infection.Conclusion. Inhaled AMB may be an alternative to commonly used adjunctive antifungal therapy in the treatment of ABPA. More data are needed on safety and efficacy.

scholarly journals Voriconazole Use for Endemic Fungal Infections

2009 ◽  
Vol 53 (4) ◽  
pp. 1648-1651 ◽  
Author(s):  
Alison Freifeld ◽  
Laurie Proia ◽  
David Andes ◽  
Larry M. Baddour ◽  
Janis Blair ◽  
...  
Keyword(s):  
Prospective Studies ◽  
Retrospective Review ◽  
Salvage Therapy ◽  
Fungal Infections ◽  
Endemic Mycoses

ABSTRACT In a retrospective review of 24 patients with histoplasmosis, blastomycosis, or coccidioidomycosis treated with voriconazole (most for salvage therapy), the outcome was favorable (improved or stable) for 22 (95.8%) within 2 months of starting voriconazole and for 20 (83.3%) at the last follow-up. Prospective studies are required to determine its role in the treatment of endemic mycoses.

5-Azacytidine (5-AZA) Salvage Therapy for Very High Risk Acute Myeloid Leukemia (AML): Response After 3 Cycles Is the Major Determinant for Outcome.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 2044-2044
Author(s):  
Sameh Ayari ◽  
Patrice Chevallier ◽  
Thierry Guillaume ◽  
Eolia Brissot ◽  
Steven Le Gouill ◽  
...  
Keyword(s):  
Stem Cell ◽  
High Risk ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Stable Disease ◽  
Salvage Therapy ◽  
Secondary Aml ◽  
Group Iii ◽  
Group I ◽  
Very High

Abstract Abstract 2044 Poster Board II-21 Very high risk AML can be categorized into three groups: i) group I: AML in second relapse or refractory after 2 induction regimens and AML in relapse after stem cell transplantation in patients aged <60 years, ii) group II: AML in first relapse in patients aged >60 years or secondary AML with unfavourable karyotype, iii) group III: AML in patients aged >70 years with either unfavourable karyotype or secondary AML. In this subgroup of very high risk AML, results of conventional chemotherapy are very poor and overall survival (OS) does not exceed a few weeks. Recently, an ever-growing body of evidence suggested that 5-AZA, a hypomethylating agent approved in high risk myelodysplastic syndromes, might also have some potent anti-leukemic activity. The aim of this pilot study was to assess the feasibility and efficacy of 5-AZA in a single centre cohort of 58 patients with very high risk relapsed or refractory AML. Between 2006 and 2009, 58 consecutive patients received 5-AZA subcutaneously (75 mg/m2/d) for 7 days every 4 weeks (one cycle= 7 days of treatment). Response after 3 cycles was assessed by marrow examination according to the IWG criteria. 5-AZA was continued after 3 cycles, if patients were at least in stable disease and/or until progression. In this series, the median age was 66 years (range, 28-80; 32 males and 26 females). AML features were: favourable and intermediate karyotype, 59% (n=34); unfavourable karyotype, 38% (n=22); secondary AML, 57% (n=33). Distribution according to AML risk groups were: group I, 26% (n=15); group II, 50% (n=29); group III, 24% (n=14). Of note, 16% of patients (n=9) from the entire cohort had received and failed a previous stem cell transplant. In all, a mean of 4.5 cycles (range, 1-14) of 5-AZA could be administered. 48% of patients (n=28) could achieve an overall response (OR) including CR, complete remission with incomplete blood recovery (CRi), partial remission (PR) and stable disease (SD). The “CR+CRi” rate was 19% (n=11). Interestingly, 13 patients (22%) were not able to receive the full first 3 cycles of 5-AZA, with 8 early deaths and 5 treatment discontinuation before evaluation. The main causes of early death and treatment discontinuation were severe infections and/or haemorrhage. In univariate analysis, age, AML risk group, karyotype, secondary AML feature, did not prove to be significantly associated with the rate of OR. With a median follow-up of 10,5 (range, 0,6-36) months, the Kaplan-Meier estimate of OS was 13% (95%CI, 3.4-30%) at 24 months. The median OS was 13.5 (95%CI, 11-not reached) months for patients achieving at least a stable disease after 3 cycles of 5-AZA versus 4 (95% CI, 3.29-5.44) months (p<0.0001) for the rest of the cohort. In multivariate analysis including response to 3 cycles of 5-AZA, cytogenetics, secondary AML featureand AML risk group only achievement of an OR after 3 cycles of therapy and a favourable karyotype, proved to be significantly associated with an improved OS (HR=0.10, p<0.001; and HR=0.36, p=0.012; respectively).Among patients achieving CR or CRi,6 patients were able to proceed to allogeneic stem cell transplantation and are currently alive in sustained CR. We conclude that 5-AZA is a feasible salvage therapy for relapsed or refractory AML with a relatively acceptable toxicity. Survival advantage is mainly observed in those patients achieving at least a stable disease after 3 cycles of therapy, and in patients who can proceed to consolidation with allogeneic stem cell transplantation, highlighting the need for large scale multicenter prospective studies assessing the role of 5-AZA as salvage therapy for high risk AML. Disclosures: No relevant conflicts of interest to declare.

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