Ef64257; cacy and safety of caspofungin in paediatric allogeneic haematopoietic stem cell transplantation: a single-centre study

Ref ID: 18583

Author:

A. Dony (1), M.P. Goutagny (1), Y. Bertrand (1), A. Bienvenu
(2), J.M. André (1), N. Bleyzac (1), V. Mialou (1)

Author address:

(1)IHOP (Lyon, FR); (2)Hôpital de la croix rousse (Lyon, FR)

Full conference title:

Annual Meeting of the EBMT, 36th

Abstract:

The aim of this study was to evaluate the effi cacy and the
tolerance of caspofungin during allogeneic Haematopoietic
Stem Cell Transplantation (HSCT).
Methods: We performed a retrospective analysis of 123 consecutive children who received HSCT between January 2004
and December 2008. Sixty one patients were treated by
caspofungin at least 3 days, from the beginning of conditioning
regimen until the 60th day post-transplant (dose: 50 mg/m²).
Three groups of caspofungin treatment have been identifi ed:
group 1 received empiric therapy, group 2 received secondary
prophylaxis and group 3 was treated for fungal infection occurring during HSCT process. In group 3 caspofungin was given
in combination with voriconazole (3) or liposomal amphotericin
B (2). Success of the treatment was evaluated according to
following criteria: non-occurrence of fungal infection for group
1, absence of fungal infection recurrence for group 2 and fungal
infection resolution in group 3.
Results: Among the 61 patients treated by Caspofungin, 36 had
HSCT for malignancies and 25 for other diseases. Median age
at HSCT was 9,2 years. Donors were of unrelated origin for 38
patients, familial HLA identical siblings for 20 and familial haploidentical for 3. Forty two patients were in the group 1 (empiric),
14 in group 2 (secondary prophylaxis for aspergillosis (n = 4) or
for disseminated candidiasis (n = 9), missing data for 1) and 5 in
group 3 (as curative treatment for aspergillosis (n = 4) or candidiasis (n = 1)). Results are detailed in the Table 1.
In group 1 the only treatment failure was the occurrence of a
pulmonary aspergillosis.
In group 2, there was no recurrence of the previous fungal
infection.
In group 3, all patients received antifungal bitherapy. Among them,
2 patients died of fungal infection (one disseminated candidiasis
and one because obstructive endobronchial aspergillosis).
Concerning the tolerance, among the 3 groups of treatment
only one therapy has been discontinued, for suspected hepatic
toxicity of Caspofungin (not confi rmed), in a patient presenting
at the same time a grade 4 hepatic acute Graft Versus Host
Disease.
Conclusion: Caspofungin displayed favourable safety and may
have antifungal effi cacy in pediatric allogeneic HSCT.

Abstract Number: P755

Conference Year: 2010

Link to conference website: NULL

New link: NULL

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