The Deferasirox-AmBisome Therapy for Mucormycosis (DEFEAT Mucor) Study

Inclusion Criteria:

- Age greater than 2 years.

- Proven or probable invasive mucormycosis, as defined by modification of consensus
European Organization for Research and Treatment of Cancer (EORTC)/Mycosis Study
Group (MSG) criteria. In brief, proven mucormycosis is defined as: 1)
histopathologic or cytopathologic examination showing broad-based, aseptate,
ribbon-like hyphae consistent with Mucorales from needle aspiration or biopsy
specimen, with evidence of associated tissue damage (either microscopically or
unequivocally by imaging); OR 2) a positive culture result for a sample obtained by
sterile procedure from normally sterile and clinically or radiologically abnormal
site consistent with infection, excluding urine and mucous membranes. Probable
mucormycosis is defined as: 1) an at-risk host; AND 2) positive culture, cytology, or
polymerase chain reaction (PCR) test (run at a CLIA-certified clinical microbiology
laboratory) from sputum, bronchoalveolar lavage (BAL), endoscopy/colonoscopy, or
sinus aspirate/biopsy; AND 3) 1 major or 2 minor clinical criteria.

- Radiographic study by Computerized Tomography (CT) or Magnetic Resonance Imaging
(MRI) has been obtained within 4 calendar days prior to enrollment and shows evidence
of infection (i.e. focal nodule, mass, or abscess, or enhancement, or evidence of
tissue edema or destruction that is not attributed to post-surgical reaction).

- Subject or authorized decision maker able to provide informed consent.

Exclusion Criteria:

- High likelihood of death within the 48 h after enrollment (investigator's
discretion).

- High likelihood of death due to factors unrelated to mucormycosis (e.g. due to
uncontrolled and/or relapsed malignancy, severe graft versus host disease, other
underlying diseases, etc.) within 30 days following enrollment (investigator's
discretion).

- Patient unable to receive enteral medication (oral or via feeding tube).

- Infection limited to the supra-fascial skin (skin lesions in the presence of
disseminated disease, deep invasive tissue infection spreading from a primary skin
site, or subcutaneous infections extending to fascia are allowed).

- Patient has received > 14 days of polyene antifungal therapy (i.e. amphotericin B
deoxycholate, liposomal amphotericin B, amphotericin B lipid complex, or amphotericin
B colloidal dispersion) at the time of screening.

- Patient is already taking deferasirox therapy for any reason at the time of
screening.

- Patient is allergic to or intolerant of deferasirox or LAmB.

- Patient has significant renal dysfunction at the time of screening, defined as serum
creatinine of > 3 mg/dL or a calculated creatinine clearance of < 30 ml/min (by the
Cockroft-Gault formula: (140 - age (yrs) * wt (kg)) * 0.85 (for females) / (72 *
serum creatinine (mg/dL)).

- Patient has significant hepatic dysfunction at the time of screening, defined as BOTH
an AST or ALT > 10 times the upper limit of normal, AND a direct (not total)
bilirubin > 5 times the upper limit of normal.

- Women of child-bearing potential (those with menses within the last year) with a
positive serum pregnancy test.

- Enrollment refused by the primary physician.