amphotericin-b and Osteosarcoma

Mucormycosis are opportunistic infections mostly observed in immunocompromised patients. We report the case of a 13-year-old girl who suffered a systemic mucormycosis without presenting the usual risk factors. She was undergoing antineoplastic chemotherapy for advanced osteosarcoma of the femur with an uncommunicative pathologic fracture and pulmonary metastasis. Absidia corymbifera was isolated from skin lesions at the primary tumor site. She subsequently developed fungal pulmonary localizations and blood vessel thrombosis. Surgical treatment together with systemic, high doses of liposomal amphotericin B, posaconazole, and caspofungin cured the local infection and controlled systemic lesions. Unfortunately, the break in chemotherapy led to pulmonary metastasis progression.

Topics: Absidia; Adolescent; Amphotericin B; Antineoplastic Agents; Caspofungin; Drug Therapy, Combination; Echinocandins; Female; Femoral Neoplasms; Humans; Lipopeptides; Mucormycosis; Opportunistic Infections; Osteosarcoma; Triazoles

Leishmaniasis refers to a spectrum of diseases caused by Leishmania. Clinically, three types of leishmaniasis can be distinguished: the cutaneous, mucous and visceral leishmaniasis, the latter being caused by Leishmania donovani.. An 11-year-old Thai, living in Belgium for 6 years, had surgery for a vertebral osteosarcoma with pulmonary metastases, followed by polychemotherapy, then pulmonary metastasectomy. During a post-chemotherapy bone marrow aplasia, febrile episode with a general condition impairment was noted and first treated by broad-spectrum antibiotherapy, then by amphotericin B, in the absence of any accurate etiology. The outcome first was favorable. Nevertheless, 7 months later, the visceral leishmaniasis diagnosis was made because of the recurrence of the same symptoms. Classical treatments by antimony derivatives (Glucantim), then liposomal amphotericin (Ambisome) proved to be inefficient. A liposomal amphotericin-gamma interferon association suppressed the symptoms without eradicating the parasite. The patient was given a maintenance therapy based on liposomal amphotericin.. The stubborn and recurring nature of this chronic visceral leismaniosis can be due to the immune deficit inherent in the polychemotherapy performed in order to treat the metastatic osteosarcoma which currently is in first full remission.

Topics: Amphotericin B; Antifungal Agents; Antimony; Antineoplastic Combined Chemotherapy Protocols; Antiprotozoal Agents; Child; Chronic Disease; Humans; Interferon-gamma; Leishmaniasis, Visceral; Liposomes; Lung Neoplasms; Male; Meglumine; Meglumine Antimoniate; Organometallic Compounds; Osteosarcoma; Recurrence; Spinal Neoplasms

Amphotericin B (AmB), a polyene antifungal antibiotic, has been shown to potentiate the cytotoxic effect of different chemotherapeutic drugs in vivo and in vitro. The purpose of this study was to determine whether AmB could enhance the carboplatin antitumor activity in a human osteosarcoma xenograft model. Nude mice, bearing s.c. transplanted osteosarcoma xenografts, received i.p. an injection of AmB (5 mg/kg) 6 h prior to carboplatin (20 mg/kg) or each of the drugs separately. The effect of treatment was assessed by analyzing tumor growth delay and T/C ratio. Carboplatin clearly reduced tumor growth when administered alone. However, an unexpected interaction was seen where AmB significantly decreased the antitumor effect of carboplatin. The present results contradict some earlier in vitro studies and indicate the complexity of this interaction in vivo. Hence, it seems that interactive phenomena in one experimental model, and especially with regard to AmB, cannot be universally applied to all experimental situations.

Topics: Amphotericin B; Animals; Antifungal Agents; Antineoplastic Agents; Bone Neoplasms; Carboplatin; Cell Division; Drug Interactions; Female; Humans; Mice; Mice, Inbred BALB C; Osteosarcoma; Transplantation, Heterologous

Topics: Administration, Oral; Adolescent; Amphotericin B; Anorexia; Blood Platelets; Blood Transfusion; Candidiasis; Drug Eruptions; Humans; Infusions, Parenteral; Injections, Intramuscular; Leucovorin; Methotrexate; Nausea; Osteosarcoma; Pneumothorax; Stomatitis; Vomiting