| High-dose caspofungin combination antifungal therapy in patients with hematologic malignancies and hematopoietic stem cell transplantation. | |
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MedLine Citation:
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PMID: 17245424 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Pneumocandins have concentration-dependent antifungal activity and higher dose of caspofungin (HD-CAP) in combination with other licensed antifungal therapy (OLAT) may improve response. Thirty-four patients who received HD-CAP were compared with 63 patients who received standard dose (SD)-CAP. There were no differences between the groups in either patient or disease characteristics. Significantly more patients in the HD-CAP arm had extrapulmonary infections (29 vs 8% in SD group; P=0.0053), and non-Aspergillus species infection (21 vs 6%; P=0.05) and had received prior antifungal therapy (71 vs 33%; P=0.0004). No serious adverse reactions were noted in patients receiving HD- or SD-CAP therapy. Twelve weeks after treatment commenced 44% had a complete or partial response compared with 29% in SD-CAP group (P=0.1). Logistic regression analysis showed a significant probability of a favorable outcome at 12 weeks in patients who received HD-CAP (OR 3.066, 95% CI, 1.092-8.61; P=0.033). This may in part reflect higher number of patients in HD group had received granulocyte-macrophage colony-stimulating factor (41 vs 14% in SD group; P=0.04) and/or interferon gamma (26 vs 5% in SD group; P=0.003) immune enhancement. Further studies are needed to evaluate efficacy of HD-CAP in severely immunosuppressed cancer patients with invasive fungal infections. |
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Authors:
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A Safdar; G Rodriguez; K V I Rolston; S O'Brien; I F Khouri; E J Shpall; M J Keating; H M Kantarjian; R E Champlin; I I Raad; D P Kontoyiannis |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Bone marrow transplantation Volume: 39 ISSN: 0268-3369 ISO Abbreviation: Bone Marrow Transplant. Publication Date: 2007 Feb |
Date Detail:
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Created Date: 2007-01-24 Completed Date: 2007-03-27 Revised Date: 2008-11-21 |
Medline Journal Info:
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Nlm Unique ID: 8702459 Medline TA: Bone Marrow Transplant Country: England |
Other Details:
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Languages: eng Pagination: 157-64 Citation Subset: IM |
Affiliation:
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Department of Infectious Diseases, Infection Control, and Employee Health, MD Anderson Cancer Center, Houston, TX 77030, USA. asafdar@mdanderson.org |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Antifungal Agents / therapeutic use*, toxicity Dose-Response Relationship, Drug Drug Therapy, Combination Echinocandins Female Granulocyte-Macrophage Colony-Stimulating Factor / therapeutic use Hematologic Neoplasms / complications*, drug therapy*, therapy Hematopoietic Stem Cell Transplantation / adverse effects, methods* Humans Infection / chemically induced Interferon-gamma / therapeutic use Male Middle Aged Peptides, Cyclic / administration & dosage*, toxicity Remission Induction Retrospective Studies Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Antifungal Agents; 0/Echinocandins; 0/Peptides, Cyclic; 0/caspofungin; 82115-62-6/Interferon-gamma; 83869-56-1/Granulocyte-Macrophage Colony-Stimulating Factor |
| Comments/Corrections | |
Comment In:
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Bone Marrow Transplant. 2007 Feb;39(3):129-31
[PMID:
17245422
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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