Caspofungin first-line therapy for invasive aspergillosis in allogeneic hematopoietic stem cell transplant patients: an European Organisation for Research and Treatment of Cancer study
Por:
Herbrecht, R, Maertens, J, Baila, L, Aoun, M, Heinz, W, Martino, R, Schwartz, S, Ullmann, AJ, Meert, L, Paesmans, M, Marchetti, O, Akan, H, Ameye, L, Shivaprakash, M, Viscoli, C
Publicada:
1 jul 2010
Resumen:
Caspofungin at standard dose was evaluated as first-line monotherapy of mycologically documented probable/proven invasive aspergillosis (IA) (unmodified European Organisation for Research and Treatment of Cancer/Mycosis Study Group criteria) in allogeneic hematopoietic SCT patients. The primary efficacy end point was complete or partial response at end of caspofungin treatment. Response at week 12, survival and safety were additional end points. Enrollment was stopped prematurely because of low accrual, with 42 enrolled and 24 eligible, giving the study a power of 85%. Transplant was from unrelated donors in 16 patients; acute or chronic GVHD was present in 15. In all, 12 patients were neutropenic (<500/mu l) at baseline, 10 received steroids and 16 calcineurin inhibitors or sirolimus. Median duration of caspofungin treatment was 24 days. At the end of caspofungin therapy, 10 (42%) patients had complete or partial response (95% confidence interval: 22-63%); 1 (4%) and 12 (50%) had stable and progressing disease, respectively; one was not evaluable. At week 12, eight patients (33%) had complete or partial response. Survival rates at week 6 and 12 were 79 and 50%, respectively. No patient had a drug-related serious adverse event or discontinued because of toxicity. Caspofungin first-line therapy was effective and well tolerated in allogeneic hematopoietic SCT patients with mycologically documented IA. Bone Marrow Transplantation (2010) 45, 1227-1233; doi: 10.1038/bmt.2009.334; published online 11 January 2010
Filiaciones:
Herbrecht, R:
Hop Hautepierre, Dept Hematol & Oncol, F-67098 Strasbourg, France
Maertens, J:
Univ Ziekenhuizen Leuven, Dept Hematol, Acute Leukemia & Transplantat Unit, Leuven, Belgium
Baila, L:
EORTC, Brussels, Belgium
Aoun, M:
Free Univ Brussels, Inst Jules Bordet, Brussels, Belgium
Heinz, W:
Univ Wurzburg, Med Ctr, Div Infect Dis, Dept Internal Med 2, Wurzburg, Germany
Martino, R:
Univ Autonoma Barcelona, Hosp Santa Creu i St Pau, Serv Hematol, E-08193 Barcelona, Spain
Schwartz, S:
Charite B Franklin, Dept Hematol & Oncol, Berlin, Germany
Ullmann, AJ:
Johannes Gutenberg Univ Mainz, Univ Med, Mainz, Germany
Meert, L:
EORTC, Brussels, Belgium
Paesmans, M:
EORTC, Brussels, Belgium
Marchetti, O:
CHU Vaudois, Dept Med, Infect Dis Serv, CH-1011 Lausanne, Switzerland
Univ Lausanne, Lausanne, Switzerland
Akan, H:
Ankara Univ, Sch Med, Dept Hematol, TR-06100 Ankara, Turkey
Ankara Univ, Sch Med, Stem Cell Transplantat Unit, TR-06100 Ankara, Turkey
Ameye, L:
Free Univ Brussels, Inst Jules Bordet, Brussels, Belgium
Viscoli, C:
Univ Genoa, San Martino Univ Hosp, Div Infect Dis, Genoa, Italy
Bronze
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