Successful Treatment of Lung Aspergillus terreus Infection After a Second Hematopoietic Stem Cell Transplant in a Patient With Myelodysplastic Syndrome

Exp Clin Transplant. 2019 Jun;17(3):425-428. doi: 10.6002/ect.2016.0319. Epub 2017 Dec 18.

Abstract

A 24-year-old man was diagnosed with myelodysplastic syndrome and received a haploidentical hematopoietic stem cell transplant. The patient experienced graft failure posttransplant. Analysis of specific antibodies revealed that the patient had strongly positive donor-specific antibodies; therefore, we changed the donor to the patient's mother and added a single unit of cord blood to perform the second transplant. Corresponding treatments targeting donor-specific antibodies were administered to reverse the graft rejection and to reduce the antibody load. The grafts were implanted successfully, but the patient developed an invasive fungal infection. A lung biopsy was performed, and the pathogen was confirmed to be Aspergillus terreus via gene sequencing and analysis. The combined treatment of micafungin and posaconazole had good efficacy in this case, and this patient now receives close follow-up and receives oral posaconazole for antifungal maintenance treatment.

Publication types

  • Case Reports

MeSH terms

  • Antifungal Agents / therapeutic use*
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Male
  • Micafungin / therapeutic use*
  • Myelodysplastic Syndromes / surgery*
  • Postoperative Complications / drug therapy*
  • Pulmonary Aspergillosis / drug therapy*
  • Remission Induction
  • Triazoles / therapeutic use*
  • Young Adult

Substances

  • Antifungal Agents
  • Triazoles
  • posaconazole
  • Micafungin