FUNGEMIA IN PATIENTS WITH HEMATOLOGIC MALIGNANCIES - THERAPEUTIC EFFECTS OF CONCOMITANT ADMINISTRATION OF FLUCONAZOLE AND GRANULOCYTE-COLONY-STIMULATING FACTOR

Serum (beta 1 --> 3)-D-glucan was elevated in 34 of 126 patients (27%) with hematologic malignancy who were clinically suspected of having a deep-seated mycosis. Although 11 patients (8.8%) were though to have fungemia, fungi were isolated from blood culture in only 4. These resu lts suggest that measurement of serum beta-D-glucan is useful for earl y diagnosis. Therapy with fluconazole (FLCZ) was effective in 9 of 11 patients (81.8%) suspected of having fungemia. Fungemia responded in 5 of 7 patients who were given granulocyte-colony-stimulating factor (G -CSF) concomitantly with FLCZ. This result suggested that administrati on of G-CSF with FLCZ was useful therapy for fungemia, which may occur during granulocytopenia following chemotherapy with anticancer agents .