Caspofungin plus posaconazol as salvage therapy of invasive fungal infections in haematopoietic cell transplantation

Ref ID: 18590

Author:

H. Lellek, F. Dahlke, F.A. Ayuk, C. Wolschke, N. Kr ö ger,
A.R. Zander

Author address:

Clinic for Stem Cell Transplantation (Hamburg, DE)

Full conference title:

Annual Meeting of the EBMT, 36th

Abstract:

Background: Substantial improvements of treatment against
invasive fungal infections have been achieved by the introduction of new antifungal agents including azoles (e.g. posaconazol) and echinocandins (e.g. caspofungin). However, mortality
associated with treatment-refractory aspergillosis remains high.
Preliminary data suggest that combination of azoles and echinocandins may increase activity against refractory invasive
aspergillosis (IA).
Objective: In the present study we evaluated the effi ciency and
safety of caspofungin and posaconazol for salvage therapy in
hematopoietic cell transplantation.
Patients and methods: In this monocentric, retrospective study,
32 hospitalized hematopoietic cell transplant recipients with IA
refractory to primary treatment were treated with a combination
therapy of caspofungin 1 x 50 mg and posaconazol 4 x 200 mg.
Effi cacy was assessed by clinical symptoms and the degree of
pulmonary infi ltrate regression.
Results: A favorable response was seen in the majority of
patients (78%). In two patients (6%) clinical improvement, but
no decline in pulmonary infi ltrates was observed. Five patients
(16%) did not respond to combination treatment with a fatal outcome in four of them. Combination therapy was well tolerated.
No patient discontinued treatment due to toxicity.
Conclusion: This study indicates that the combination of caspofungin and posaconazol may provide an effective and tolerable
therapy of IA in immunocompromised patients refractory to primary treatment.

Abstract Number: P787

Conference Year: 2010

Link to conference website: NULL

New link: NULL

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