4 children with various malignant conditions developed pulmonary aspergillosis during chemotherapy. All patients were treated with high doses of liposomal Amphotericin B. 2 patients (acute myelogenous leukemia/neuroblastome stage IV) died not recovering from bone marrow aplasia, one of them from penetration into the myocardium, the other one due to pulmonary embolism and penetration through the diaphragm into the liver. 2 patients recovered from bone marrow aplasia and survived after surgery of the pulmonary lesions. One patient (B-Non-Hodgkin-Lymphoma) had pneumonectomy of the right lung following intraoperative rupture of the invaded pulmonary artery, and in one patient (osteogenic sarcoma) 20 pulmonary aspergillus granulomas were removed. We conclude that not only surgery but also recovery of granulocytes supported by G-CSF were essential for survival in these 2 patients. Liposomal Amphotericin 8 is of value to stabilize the clinical condition until consolidation of the pulmonary lesions due to granulocyte recovery occurs as a prerequisite of successful surgery.
Full conference title:
18th International Congress of Chemotherapy
- ICC 18th