Transplanted patients with a history of invasive fungal infection (IFI) are at high risk of developing relapse and fatal complications. Eighteen patients affected by hematological malignancies and a previous IFI were submitted to allogeneic stem cell transplantation, using Caspofungin as a secondary prophylaxis. Patients had a probable or proven fungal infection and 16 had a pulmonary localization. No side effects were recorded during treatment with Caspofungin. Compared to pre-transplant evaluation, stability or improvement of the previous IFI was observed in 16 of the 18 patients at day 30, in 13 of the 15 evaluable patients at day 180 and in 11 of the 11 evaluable patients at day 360 post transplant. In particular, all the six patients with a proven fungal infection were alive, with a stable or improved IFI after 1 year from transplant. At a maximum follow-up of 31 months, eight patients died for disease progression or transplant-related complications, but only two had evidence of fungal progression. Secondary prophylaxis with Caspofungin may represent a suitable approach to limit IFI relapse or progression, allowing patients with hematological malignancies to adhere to the planned therapeutic program.

de Fabritiis, P., Spagnoli, A., Di Bartolomeo, P., Locasciulli, A., Cudillo, L., Milone, G., et al. (2007). Efficacy of caspofungin as secondary prophylaxis in patients undergoing allogeneic stem cell transplantation with prior pulmonary and/or systemic fungal infection. BONE MARROW TRANSPLANTATION, 40(3), 245-249 [10.1038/sj.bmt.1705720].

Efficacy of caspofungin as secondary prophylaxis in patients undergoing allogeneic stem cell transplantation with prior pulmonary and/or systemic fungal infection

de Fabritiis, P;CUDILLO, LAURA;PICARDI, ALESSANDRA;
2007

Abstract

Transplanted patients with a history of invasive fungal infection (IFI) are at high risk of developing relapse and fatal complications. Eighteen patients affected by hematological malignancies and a previous IFI were submitted to allogeneic stem cell transplantation, using Caspofungin as a secondary prophylaxis. Patients had a probable or proven fungal infection and 16 had a pulmonary localization. No side effects were recorded during treatment with Caspofungin. Compared to pre-transplant evaluation, stability or improvement of the previous IFI was observed in 16 of the 18 patients at day 30, in 13 of the 15 evaluable patients at day 180 and in 11 of the 11 evaluable patients at day 360 post transplant. In particular, all the six patients with a proven fungal infection were alive, with a stable or improved IFI after 1 year from transplant. At a maximum follow-up of 31 months, eight patients died for disease progression or transplant-related complications, but only two had evidence of fungal progression. Secondary prophylaxis with Caspofungin may represent a suitable approach to limit IFI relapse or progression, allowing patients with hematological malignancies to adhere to the planned therapeutic program.
Pubblicato
Rilevanza internazionale
Articolo
Esperti anonimi
Settore MED/15 - Malattie del Sangue
Settore MED/05 - Patologia Clinica
English
Con Impact Factor ISI
aciclovir; amphotericin B lipid complex; antibiotic agent; antifungal agent; caspofungin; ciprofloxacin; foscarnet sodium; ganciclovir; itraconazole; levofloxacin; voriconazole; absence of side effects; adult; allogeneic stem cell transplantation; article; clinical article; controlled study; cytomegalovirus infection; death; disease course; drug efficacy; drug safety; drug substitution; drug withdrawal; female; follow up; hematologic malignancy; human; loading drug dose; lung infection; male; mycosis; priority journal; relapse; secondary prevention; vein occlusion; Adult; Antifungal Agents; Disease-Free Survival; Echinocandins; Female; Hematologic Diseases; Humans; Lung Diseases, Fungal; Male; Middle Aged; Recurrence; Retrospective Studies; Stem Cell Transplantation; Survival Rate; Transplantation, Homologous
de Fabritiis, P., Spagnoli, A., Di Bartolomeo, P., Locasciulli, A., Cudillo, L., Milone, G., et al. (2007). Efficacy of caspofungin as secondary prophylaxis in patients undergoing allogeneic stem cell transplantation with prior pulmonary and/or systemic fungal infection. BONE MARROW TRANSPLANTATION, 40(3), 245-249 [10.1038/sj.bmt.1705720].
de Fabritiis, P; Spagnoli, A; Di Bartolomeo, P; Locasciulli, A; Cudillo, L; Milone, G; Busca, A; Picardi, A; Scime, R; Bonini, A; Cupelli, L; Chiusolo, P; Olivieri, A; Santarone, S; Poidomani, M; Fallani, S; Novelli, A; Majolino, I
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2108/36849
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