Triple antifungal therapy for severe XXXX allowed performance of allogeneic stem cell transplantation.

@entity1 @entity981 @entity6923 @entity295 @entity3217 @entity2380 @entity2379 @entity3052 @entity1503 @entity364 @entity5074 @entity11511 @entity11794
@entity6923 is a rare but life threatening complication in immunosuppressed @entity1 undergoing allogeneic SCT. Combination of new antifungal agents may improve outcome in this @entity1 population. Here, triple anti-mycotic therapy is described in an relapsed @entity981 @entity1 in urgent need of allogeneic bone marrow transplantation. The @entity1 with @entity11511 of thymic differentiation achieved remission after treatment according to the German @entity981 protocol 07/03. Two months after the consolidation therapy relapse occurred requiring high dose chemotherapy with allogeneic stem cell transplantation. One day after start of the conditioning regimen the @entity1 showed skin manifestations typical for @entity3217 and @entity1503 became positive for Candida krusei while on @entity2380 prophylaxis. Because of the limited sensibility of @entity2380 resistant candida species to liposomal @entity2379 and the high mortality rate in @entity1 with @entity6923 , @entity5074 was added immediately to liposomal @entity2379 . Since fever did not resolve and the conditioning therapy for allogeneic transplantation was not yet completed @entity11794 was added. Skin manifestation responded to this triple anti-mycotic combination and peripheral blood stem cells from an unrelated donor were transplanted. With the triple antifungal therapy the @entity1 finally became afebrile, skin manifestations showed complete resolution and @entity1503 became negative. Three months after the onset of @entity6923 the @entity1 was fully active with no signs of @entity364 and in haematological and molecular remission. @entity295 at the start of myeloablative conditioning therapy in heavily pretreated @entity3052 @entity1 is usually considered as not allowing successful allogeneic transplantation. Thus this case demonstrates, that allogeneic stem cell transplantation is feasible in @entity1 presenting with @entity6923 if combined antifungal therapy with liposomal @entity2379 , @entity11794 and @entity5074 is given.
