33 research outputs found

    Pulmonary aspergillosis caused by a pan-azole-resistant Aspergillus fumigatus in a 10-year-old boy

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    Item does not contain fulltextA 10-year-old boy with high-risk acute lymphoblastic leukemia treated with hematopoietic stem-cell transplantation developed pulmonary aspergillosis while receiving prophylactic voriconazole. A transpleural aspirate culture revealed a pan-azole-resistant Aspergillus fumigatus. Treatment with liposomal amphotericin B resulted in complete recovery. As the frequency of azole resistance in A. fumigatus increases, invasive procedures to isolate fungi for species identification and susceptibility testing becomes even more important

    Access to allogeneic hematopoietic SCT for patients with MDS or relapsed AML treated according to protocols of the Dutch Childhood Oncology Group

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    To investigate whether all patients in need of an allogeneic hematopoietic SCT (HSCT) are offered one, we retrospectively investigated the policy for all children diagnosed with myelodysplastic syndrome (n=90) or relapsed AML (n=75) between 1998 and 2008. These children are registered at diagnosis and treated according to protocols of the Dutch Childhood Oncology Group, which provides accurate disease incidence data and protocol-indicated appropriateness for HSCT. For 48 (30%) patients, a family donor was identified; for 90 (57%) patients, an unrelated donor (UD) search was performed; and for 21 (13%) patients, no UD search was initiated. Reasons for not initiating an UD search include: progressive disease (n=10), conserve quality of life (n=1), stable disease (n=3), immunosuppressive therapy (n=2), patient death (n=3), patient lives abroad (n=1) and second relapse (n=1). On the basis of the time interval between date of diagnosis and date of death/last follow-up, for eight (5%) patients, it may be questioned why an UD search was not performed. The fact that 95% of all children are given the option of an allogeneic HSCT is encouraging and reasons not to transplant seem fair in most cases.Bone Marrow Transplantation advance online publication, 22 August 2011; doi:10.1038/bmt.2011.168.Transplantation and autoimmunit
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