Efficacy of High-Dose (100 mg daily) Caspofungin (HD-CASP) Combination Antifungal Therapy in Cancer Patients with Invasive Fungal Infections (IFIs): Case-Controlled Observational Analysis During 2002-2004

A. Safdar*, G. Rodriguez, K.V.I. Ro[ston, H.M. Kantarjian, G.R Bodey, R.E. Champlain, D. Kontoyiannis, I.I. Raad.

Author address: 

M.D. Anderson Cancer Center Houston, TX, USA

Abstract: 

Background: Pneumocandins exert concentrationdependent antifunga[ effect, therefore we sought to evaluate efficacy (complete or partial response, C-PR) of HD-CASP therapy in patients with systemic mycosis. Methods: IRB approval was obtained to review the charts of 97 patients with probable and proven IFIs. Conventional-dose (CD) CASP was 70mg followed by 50mg daily. Fisher exact or chi-square test and student's t-test or Wi[coxon rank sums test were used to assess categorical and continuous variables, respectively. Results: Among evaluated Cases (n = 34) and controis (n = 63) there were not statistically significant differences between the two groups respect to the patients characteristics such as age, acute or chronic leukemia, BMT, GVHD, relapsed or refractory cancer, co morbidities including DM, COPD, CAD, CHF, ARF, hepatic dysfunction, APACHE-II score, >600 prednisone equivalent dose prior or during CASP therapy, neutropenia prior and during therapy, antifunga[ prophylaxis, probable and proven IFI and combination antifunga[ therapy. Logistic regression multivariate 4-weeks assessment showed no difference in response in HDand CD-CASP treatment groups, however, 12 weeks assessment showed a significantly improved probability of favorable treatment response in patients who had received HD-CASP (OR 3.066, 95% Cl 1.092-8.61, P = 0.00335). Conclusions: Despite presence of unfavorable predictors patients receiving HD-CASP had improved probability of infection resolution.
2006

abstract No: 

S94

Full conference title: 

14th International Symposium of Infections in the Immunocompromised Host
    • ISIIH, 14th