TY - JOUR
T1 - ZYGOMYCOSIS: Current approaches to management of patients with haematological malignancies.
AU - Pagano, Livio
AU - Valentini, Caterina Giovanna
AU - Caira, Morena
AU - Fianchi, Luana
PY - 2009
Y1 - 2009
N2 - Zygomycosis is an invasive infection that can occur particularly
in patients with haematological malignancy. The
causative fungi are members of the order Mucorales, and
individual species within this group require a high level of
laboratory skill to be identified. Zygomycosis can present as
rhinocerebral, pulmonary, or disseminated disease, with a
rapid clinical course. The optimal management of these cases
requires early diagnosis, aggressive antifungal therapy and,
when possible, surgical debridement. Founded on clinical
experience, but without the benefit of comparative studies,
liposomal amphotericin B has become the therapeutic agent
of choice. Posaconazole is an orally administered triazole with
a demonstrated in vitro and in vivo activity against most
Zygomycetes that is comparable to that of amphotericin B.
Studies on salvage therapy with posaconazole have yielded
promising results, and successful case reports are also
available. As an adjuvant approach, iron chelation with
deferasirox has shown promising results, although clinical
experience is still limited.
AB - Zygomycosis is an invasive infection that can occur particularly
in patients with haematological malignancy. The
causative fungi are members of the order Mucorales, and
individual species within this group require a high level of
laboratory skill to be identified. Zygomycosis can present as
rhinocerebral, pulmonary, or disseminated disease, with a
rapid clinical course. The optimal management of these cases
requires early diagnosis, aggressive antifungal therapy and,
when possible, surgical debridement. Founded on clinical
experience, but without the benefit of comparative studies,
liposomal amphotericin B has become the therapeutic agent
of choice. Posaconazole is an orally administered triazole with
a demonstrated in vitro and in vivo activity against most
Zygomycetes that is comparable to that of amphotericin B.
Studies on salvage therapy with posaconazole have yielded
promising results, and successful case reports are also
available. As an adjuvant approach, iron chelation with
deferasirox has shown promising results, although clinical
experience is still limited.
KW - leucemia
KW - zigomicosi
KW - leucemia
KW - zigomicosi
UR - http://hdl.handle.net/10807/3829
M3 - Article
SN - 0007-1048
VL - 146
SP - 597
EP - 606
JO - British Journal of Haematology
JF - British Journal of Haematology
ER -