Premium
Empirical caspofungin therapy in clinical practice for suspected invasive fungal disease in adults with acute lymphoblastic leukaemia
Author(s) -
Kiehl Michael G.,
Egerer Gerlinde,
Engelhardt Monika,
Gross Barbara
Publication year - 2015
Publication title -
mycoses
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.13
H-Index - 69
eISSN - 1439-0507
pISSN - 0933-7407
DOI - 10.1111/myc.12277
Subject(s) - caspofungin , medicine , hematopoietic stem cell transplantation , chemotherapy , retrospective cohort study , disease , pediatrics , antifungal , amphotericin b , dermatology
Summary Patients with acute lymphoblastic leukaemia ( ALL ) after cytotoxic chemotherapy or haematopoietic stem cell transplantation ( HSCT ) are at risk for life‐threatening invasive fungal disease ( IFD ). The aim was to evaluate the characteristics, antifungal therapy and outcome of adult patients with ALL after chemotherapy or HSCT receiving caspofungin empirically in a clinical setting. Retrospective chart reviews were conducted at nine large tertiary care centres in Germany. Adult patients with ALL treated empirically with caspofungin according to the product label between 2006 and 2012 were eligible. Data were extracted as case reports. In total, 25 patients (12 males, 13 females; median age 37 years; 19 with B‐ ALL , 6 with T‐ ALL ) with 28 treatment episodes because of suspected IFD (18 episodes after chemotherapy, 10 episodes after allogeneic HSCT ) were included in the analysis. Empirical caspofungin therapy (median duration: 19 days, range 1–105 days) was given as first‐line monotherapy in 20 (71.4%), second‐line monotherapy in five (17.9%) and combination therapy in three (10.7%) episodes respectively. Therapy rated successful according to the physician's overall assessment (inflammatory parameters, clinical symptoms): 20 (95%) of 21 evaluable episodes with therapy duration of at least 8 days. Empirical caspofungin appears to be an effective therapeutic option in critically ill adult ALL patients with suspected IFD in clinical practice.