Mingjuan Liu1, Yan Li2, Xiaoli Zhao2, Yongqing Zhang3, Bing Zhai2, Qingyi Zhang2, Lijun Wang2, Yu Zhao2, Honghua Li2, Quanshun Wang2, Chunji Gao2, Wenrong Huang4, Li Yu2. 1. Department of Hematology and BMT Center, Chinese PLA General Hospital 28 Fuxing Road, Beijing 100853, China ; Department of Hematology, The 309th Hospital of Chinese People's Liberation Army 17 Heishanhu Road, Beijing 100091, China. 2. Department of Hematology and BMT Center, Chinese PLA General Hospital 28 Fuxing Road, Beijing 100853, China. 3. Department of Hematology, The 309th Hospital of Chinese People's Liberation Army 17 Heishanhu Road, Beijing 100091, China. 4. Department of Hematology and BMT Center, Chinese PLA General Hospital 28 Fuxing Road, Beijing 100853, China ; Department of Hematology, Hainan Branch of Chinese PLA General Hospital Linwang Street of Sanya City, Hainan province, 572013, China.
Abstract
AIM: This study aimed to investigate the efficacy and safety of caspofungin as secondary antifungal prophylaxis (SAP) and subsequent maintenance therapy for SAP in hematological malignancy patients. METHODS: Forty four patients receiving caspofungin for SAP and 43 patients not receiving any SAP agents during their subsequent chemotherapy or HSCT were reviewed retrospectively. The clinical characteristics and diagnosis were analyzed according to the diagnostic criteria for IFD. RESULTS: The recurrence rate of IFD in 44 patients with caspofungin for SAP was 9.1% (4/44), which was much lower than that in 43 patients without SAP (9.1% vs 46.5%, P = 0.000). Patients with SAP had lower recurrent IFD-related mortality than that without SAP (12.5% vs 55.6%, P = 0.131). Among the 44 patients with SAP, caspofungin continued as maintenance antifungal prophylaxis therapy in 18 patients after neutropenia and oral medication became possible, while voriconazole in 14 patients and itraconazole in 12 patients. The recurrent IFD occurred in 2, 1, 1 patient respectively. There was no statistical difference in recurrence rates among different maintenance antifungal prophylaxis therapies (P = 0.922). No severe adverse events were observed during SAP treatment. CONCLUSIONS: Caspofungin is effective and safe to prevent IFD recurrence in hematological malignancy patients undergoing chemotherapy or HSCT. A subsequent maintenance antifungal prophylaxis therapy of oral voriconazole or itraconazole instead of caspofungin after caspofungin as SAP during neutropenia is as effective as caspofungin given constantly.
AIM: This study aimed to investigate the efficacy and safety of caspofungin as secondary antifungal prophylaxis (SAP) and subsequent maintenance therapy for SAP in hematological malignancypatients. METHODS: Forty four patients receiving caspofungin for SAP and 43 patients not receiving any SAP agents during their subsequent chemotherapy or HSCT were reviewed retrospectively. The clinical characteristics and diagnosis were analyzed according to the diagnostic criteria for IFD. RESULTS: The recurrence rate of IFD in 44 patients with caspofungin for SAP was 9.1% (4/44), which was much lower than that in 43 patients without SAP (9.1% vs 46.5%, P = 0.000). Patients with SAP had lower recurrent IFD-related mortality than that without SAP (12.5% vs 55.6%, P = 0.131). Among the 44 patients with SAP, caspofungin continued as maintenance antifungal prophylaxis therapy in 18 patients after neutropenia and oral medication became possible, while voriconazole in 14 patients and itraconazole in 12 patients. The recurrent IFD occurred in 2, 1, 1 patient respectively. There was no statistical difference in recurrence rates among different maintenance antifungal prophylaxis therapies (P = 0.922). No severe adverse events were observed during SAP treatment. CONCLUSIONS:Caspofungin is effective and safe to prevent IFD recurrence in hematological malignancypatients undergoing chemotherapy or HSCT. A subsequent maintenance antifungal prophylaxis therapy of oral voriconazole or itraconazole instead of caspofungin after caspofungin as SAP during neutropenia is as effective as caspofungin given constantly.
Authors: F Offner; C Cordonnier; P Ljungman; H G Prentice; D Engelhard; D De Bacquer; F Meunier; B De Pauw Journal: Clin Infect Dis Date: 1998-05 Impact factor: 9.079
Authors: J Maertens; O Marchetti; R Herbrecht; O A Cornely; U Flückiger; P Frêre; B Gachot; W J Heinz; C Lass-Flörl; P Ribaud; A Thiebaut; C Cordonnier Journal: Bone Marrow Transplant Date: 2010-07-26 Impact factor: 5.483
Authors: Thomas J Walsh; Hedy Teppler; Gerald R Donowitz; Johan A Maertens; Lindsey R Baden; Anna Dmoszynska; Oliver A Cornely; Michael R Bourque; Robert J Lupinacci; Carole A Sable; Ben E dePauw Journal: N Engl J Med Date: 2004-09-30 Impact factor: 91.245
Authors: Jörg J Vehreschild; Michal Sieniawski; Stefan Reuter; Dorothee Arenz; Dietmar Reichert; Johan Maertens; Angelika Böhme; Gerda Silling; Rodrigo Martino; Georg Maschmeyer; Maria J G T Rüping; Andrew J Ullmann; Oliver A Cornely Journal: Int J Antimicrob Agents Date: 2009-08-22 Impact factor: 5.283
Authors: Ben De Pauw; Thomas J Walsh; J Peter Donnelly; David A Stevens; John E Edwards; Thierry Calandra; Peter G Pappas; Johan Maertens; Olivier Lortholary; Carol A Kauffman; David W Denning; Thomas F Patterson; Georg Maschmeyer; Jacques Bille; William E Dismukes; Raoul Herbrecht; William W Hope; Christopher C Kibbler; Bart Jan Kullberg; Kieren A Marr; Patricia Muñoz; Frank C Odds; John R Perfect; Angela Restrepo; Markus Ruhnke; Brahm H Segal; Jack D Sobel; Tania C Sorrell; Claudio Viscoli; John R Wingard; Theoklis Zaoutis; John E Bennett Journal: Clin Infect Dis Date: 2008-06-15 Impact factor: 9.079