Safety and Outcomes of Open-Label Deferasirox Iron Chelation Therapy for Mucormycosis

被引：75

作者：

Spellberg, Brad ^{[1
,2
]}

Andes, David ^{[3
,4
]}

Perez, Mario ^{[5
]}

Anglim, Anne ^{[6
]}

Bonilla, Hector ^{[7
]}

Mathisen, Glenn E. ^{[8
]}

Walsh, Thomas J. ^{[9
]}

Ibrahim, Ashraf S. ^{[1
,2
]}

机构：

[1] Harbor Univ Calif LosAngeles, Div Infect Dis, Los Angeles Biomed Res Inst, Med Ctr, Torrance, CA USA

[2] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA

[3] Univ Wisconsin, Sch Med, Dept Med, Madison, WI USA

[4] Univ Wisconsin, Sch Med, Dept Med Microbiol & Immunol, Madison, WI 53706 USA

[5] Univ So Calif, Sch Med, Dept Med, Div Infect Dis, Los Angeles, CA 90033 USA

[6] Long Beach Publ Dept Hlth, Long Beach, CA USA

[7] Summa Hlth Syst, Akron, OH USA

[8] Olive View UCLA, Med Ctr, Div Infect Dis, Sylmar, CA USA

[9] NCI, Immunocompromised Host Sect, Pediat Oncol Branch, NIH, Bethesda, MD 20892 USA

来源：

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY | 2009年 / 53卷 / 07期

关键词：

AGENT; DEFEROXAMINE; ZYGOMYCOSIS; MANAGEMENT;

D O I：

10.1128/AAC.00361-09

中图分类号：

Q93 [微生物学];

学科分类号：

071005 ; 100705 ;

摘要：

We sought to describe the safety profile of open-label, adjunctive deferasirox iron chelation therapy in eight patients with biopsy-proven mucormycosis. Deferasirox was administered for an average of 14 days (range, 7 to 21) at 5 to 20 mg/kg of body weight/day. The only adverse effects attributable to deferasirox were rashes in two patients. Deferasirox treatment was not associated with changes in renal or liver function, complete blood count, or transplant immunosuppressive levels. Thus, deferasirox appears safe as an adjunctive therapy for mucormycosis.

引用

页码：3122 / 3125

页数：4

共 13 条

[1] MUCORMYCOSIS DURING DEFEROXAMINE THERAPY IS A SIDEROPHORE-MEDIATED INFECTION - INVITRO AND INVIVO ANIMAL STUDIES [J].

BOELAERT, JR ;

DELOCHT, M ;

VANCUTSEM, J ;

KERRELS, V ;

CANTINIEAUX, B ;

VERDONCK, A ;

VANLANDUYT, HW ;

SCHNEIDER, YJ .

JOURNAL OF CLINICAL INVESTIGATION, 1993, 91 (05) :1979-1986

[2] THE EFFECT OF DEFEROXAMINE ON DIFFERENT ZYGOMYCETES [J].

BOELAERT, JR ;

DELOCHT, M ;

SCHNEIDER, YJ .

JOURNAL OF INFECTIOUS DISEASES, 1994, 169 (01) :231-232

[3] Iron-chelating therapy with the new oral agent ICL670 (Exjadee®) [J].

Cappellini, MD .

BEST PRACTICE & RESEARCH CLINICAL HAEMATOLOGY, 2005, 18 (02) :289-298

[4] Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group [J].

De Pauw, Ben ;

Walsh, Thomas J. ;

Donnelly, J. Peter ;

Stevens, David A. ;

Edwards, John E. ;

Calandra, Thierry ;

Pappas, Peter G. ;

Maertens, Johan ;

Lortholary, Olivier ;

Kauffman, Carol A. ;

Denning, David W. ;

Patterson, Thomas F. ;

Maschmeyer, Georg ;

Bille, Jacques ;

Dismukes, William E. ;

Herbrecht, Raoul ;

Hope, William W. ;

Kibbler, Christopher C. ;

Kullberg, Bart Jan ;

Marr, Kieren A. ;

Munoz, Patricia ;

Odds, Frank C. ;

Perfect, John R. ;

Restrepo, Angela ;

Ruhnke, Markus ;

Segal, Brahm H. ;

Sobel, Jack D. ;

Sorrell, Tania C. ;

Viscoli, Claudio ;

Wingard, John R. ;

Zaoutis, Theoklis ;

Bennett, John E. .

CLINICAL INFECTIOUS DISEASES, 2008, 46 (12) :1813-1821

[5] A higher-level phylogenetic classification of the Fungi [J].

Hibbett, David S. ;

Binder, Manfred ;

Bischoff, Joseph F. ;

Blackwell, Meredith ;

Cannon, Paul F. ;

Eriksson, Ove E. ;

Huhndorf, Sabine ;

James, Timothy ;

Kirk, Paul M. ;

Luecking, Robert ;

Lumbsch, H. Thorsten ;

Lutzoni, Francois ;

Matheny, P. Brandon ;

Mclaughlin, David J. ;

Powell, Martha J. ;

Redhead, Scott ;

Schoch, Conrad L. ;

Spatafora, Joseph W. ;

Stalpers, Joost A. ;

Vilgalys, Rytas ;

Aime, M. Catherine ;

Aptroot, Andre ;

Bauer, Robert ;

Begerow, Dominik ;

Benny, Gerald L. ;

Castlebury, Lisa A. ;

Crous, Pedro W. ;

Dai, Yu-Cheng ;

Gams, Walter ;

Geiser, David M. ;

Griffith, Gareth W. ;

Gueidan, Cecile ;

Hawksworth, David L. ;

Hestmark, Geir ;

Hosaka, Kentaro ;

Humber, Richard A. ;

Hyde, Kevin D. ;

Ironside, Joseph E. ;

Koljalg, Urmas ;

Kurtzman, Cletus P. ;

Larsson, Karl-Henrik ;

Lichtwardt, Robert ;

Longcore, Joyce ;

Miadlikowska, Jolanta ;

Miller, Andrew ;

Moncalvo, Jean-Marc ;

Mozley-Standridge, Sharon ;

Oberwinkler, Franz ;

Parmasto, Erast ;

Reeb, Valerie .

MYCOLOGICAL RESEARCH, 2007, 111 :509-547

[6]

HOHNEKER JA, 2007, IMPORTANT INFORM EXJ

[7] The iron chelator deferasirox protects mice from mucormycosis through iron starvation [J].

Ibrahim, Ashraf S. ;

Gebermariam, Teclegiorgis ;

Fu, Yue ;

Lin, Lin ;

Husseiny, Mohamed I. ;

French, Samuel W. ;

Schwartz, Julie ;

Skory, Christopher D. ;

Edwards, John E., Jr. ;

Spellbergl, Brad J. .

JOURNAL OF CLINICAL INVESTIGATION, 2007, 117 (09) :2649-2657

[8] Deferiprone iron chelation as a novel therapy for experimental mucormycosis [J].

Ibrahim, Ashraf S. ;

Edwards, John E., Jr. ;

Fu, Yue ;

Spellberg, Brad .

JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, 2006, 58 (05) :1070-1073

[9] Deferasirox, an iron-chelating agent, as salvage therapy for rhinocerebral mucormycosis [J].

Reed, Caitlin ;

Ibrahim, Ashraf ;

Edwards, John E., Jr. ;

Walot, Irwin ;

Spellberg, Brad .

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 2006, 50 (11) :3968-3969

[10] Epidemiology and outcome of zygomycosis: A review of 929 reported cases [J].

Roden, MM ;

Zaoutis, TE ;

Buchanan, WL ;

Knudsen, TA ;

Sarkisova, TA ;

Schaufele, RL ;

Sein, M ;

Sein, T ;

Chiou, CC ;

Chu, JH ;

Kontoyiannis, DP ;

Walsh, TJ .

CLINICAL INFECTIOUS DISEASES, 2005, 41 (05) :634-653

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