Ibrahim AS, Gebremariam T, French SW et al. J Antimicrob Chemother 2010;65:289–92.
Increased levels of iron in the bone marrow of patients with hematological malignancies have been found to be an independent risk factor for the development of aspergillosis. The in vitro and in vivo effects of deferasirox on
infection were determined in this study. In vitro deferasirox was found to be fungicidal at a concentration of 50 mg/L. In a murine model of pulmonary aspergillosis, deferasirox monotherapy modestly improved survival rates; however, combination therapy with liposomal amphotericin B synergistically improved survival rates and reduced fungal burden compared with either monotherapy.
Despite the introduction of new antifungal agents, the mortality rate associated with invasive pulmonary aspergillosis remains unacceptably high. Recent data has demonstrated that iron acquisition is essential for the growth and virulence of Aspergillus spp. and that the iron level in bone marrow is an independent risk factor for the development of aspergillosis [1,2]. In this study, the in vitro and in vivo effect of deferasirox, an oral iron chelator, on Aspergillus fumigatus infection was determined.