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Successful Allogeneic Bone Marrow Transplantation Using Reduced Doses of Cyclophosphamide and Fludarabine Associated to Granulocyte Transfusions in a Patient With Severe Aplastic Anemia Complicated by an Invasive Aspergillosis of Sinuses and a Rhizopus Gingivitis

AbstractMucormycosis and invasive aspergillosis complicating severe aplastic anemia are aggressive infections associated to high mortality in the lack of rapid neutrophil and monocyte recovery. We report a child who had severe aplastic anemia complicated by sinusal invasive aspergillosis and by Rhizopus arrhizus, probably breakthrough gingivitis, which occurred under voriconazole. She underwent a rescue sibling bone marrow transplantation considered as the only chance for survive. Use of fludarabine-containing conditioning, granulocyte colony-stimulating factor allowed rapid engraftment. Granulocyte transfusion and use of amphotericin B–voriconazole association permitted infection control, which was favored by immune recovery.