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Article

Deferiprone as Adjunctive Treatment for Patients with Invasive Mucormycosis: A Retrospective Case Series

by
Maria N. Chitasombat
1,* and
Pimjai Niparuck
2
1
Division of Infectious Diseases, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchathewi, Bangkok 10400, Thailand
2
Division of Hematology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
*
Author to whom correspondence should be addressed.
Infect. Dis. Rep. 2018, 10(2), 7765; https://doi.org/10.4081/idr.2018.7765
Submission received: 31 May 2018 / Revised: 12 July 2018 / Accepted: 6 August 2018 / Published: 25 September 2018

Abstract

Mucormycosis is a life-threatening disease requiring multimodal treatment with antifungals and surgery. The mortality rate remains high, prompting consideration of alternative treatment strategies. Deferiprone has in vitro activity against Mucorales, but its efficacy has never been evaluated in humans. Here, we retrospectively analyzed patients with confirmed mucormycosis who received deferiprone from 2011 to 2017. Five patients had hematologic malignancies and one was diabetic. The sites of infection included sinus-orbit-cerebral (67%), lung (17%), and disseminated infection (17%). Surgery was performed in 83% of cases and achieved local control for 33% of patients. A combination regimen of polyenes plus echinocandins was administered with stepdown treatment using posaconazole. The median duration of antifungal treatment was 86 days (range: 46-435 days) days. Deferiprone was given as adjunctive treatment with a median dose and duration of 100 mg/kd/day (range: 86.2-100 mg/kg/day) and 25 days (range: 15-215 days), respectively. Overall, deferiprone was well-tolerated. Successful outcomes were observed at 12-week follow-up for 67% of patients. The mortality rate at 180- day follow-up was 50%. Adjunctive therapy with deferiprone showed safety and tolerability.
Keywords: deferiprone; iron chelator; mucormycosis; Mucorales deferiprone; iron chelator; mucormycosis; Mucorales

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MDPI and ACS Style

Chitasombat, M.N.; Niparuck, P. Deferiprone as Adjunctive Treatment for Patients with Invasive Mucormycosis: A Retrospective Case Series. Infect. Dis. Rep. 2018, 10, 7765. https://doi.org/10.4081/idr.2018.7765

AMA Style

Chitasombat MN, Niparuck P. Deferiprone as Adjunctive Treatment for Patients with Invasive Mucormycosis: A Retrospective Case Series. Infectious Disease Reports. 2018; 10(2):7765. https://doi.org/10.4081/idr.2018.7765

Chicago/Turabian Style

Chitasombat, Maria N., and Pimjai Niparuck. 2018. "Deferiprone as Adjunctive Treatment for Patients with Invasive Mucormycosis: A Retrospective Case Series" Infectious Disease Reports 10, no. 2: 7765. https://doi.org/10.4081/idr.2018.7765

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