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 thought to have fungemia, fungi were isolated from blood culture in only 4. These results suggest that measurement of serum beta-D-glucan is useful for early 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 administration of G-CSF with FLCZ was useful therapy for fungemia, which may occur during granulocytopenia following chemotherapy with anticancer agents.