Abstract
Caspofungin is an echinocandin with proven efficacy in invasive candidiasis (IC) and invasive aspergillosis (IA). This multicenter, prospective, non-comparative, observational ProCAS study was aimed to assess the effectiveness and safety of caspofungin in adult hematological patients with IC or IA under everyday clinical conditions. Favorable outcomes included complete and partial responses on the last day of caspofungin therapy. Safety was assessed up to 14 days post-caspofungin. A total of 115 patients (69 male) with a median age of 52 years (range, 23–78 years) were analyzed. Underlying disease was acute myeloid leukemia in 45 patients (39%), and 21 (18%) were allogeneic stem cell transplant recipients. Thirty-four (29.5%) patients had a diagnosis of IA and 26 (22.6%) had IC (candidemia). The median duration of caspofungin therapy was 14 days (range, 1–100). The overall favorable response rate was 77% (20/26) for patients with IC (69% first-line) and 79% (27/34) for those with IA. Antifungal therapy with caspofungin was generally well tolerated, only two (1.7%) patients having a non-serious drug-related adverse reaction. These results suggest that caspofungin, either alone or in combination, should be considered an effective and safe option for the treatment of invasive mycoses in patients with severe hematological disorders.
Acknowledgement
This study was sponsored by the Spanish PETHEMA Group, supported by a grant from MSD Spain 04-00112-E0.
Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.
This paper was first published online on Early Online on 18 June 2012.
Appendix: Participating Centers
Jarque & M. A. Sanz, Hospital Universitario La Fe, Valencia (23); M. Tormo, Hospital Clínico Universitario, Valencia (14); L. Bello, Complejo Hospitalario Universitario, Santiago de Compostela (14); M. Rovira, Hospital Clínic, Barcelona (11); M. Batlle, Hospital Universitari Germans Trias i Pujol, Badalona (7); A. Julià, Hospital Vall d’Hebron, Barcelona (6); S. Tabares, Hospital Reina Sofía, Córdoba (5); C. Rivas, Hospital General Universitario, Alicante (4); A. Fernández-Sevilla, Institut Català d’Oncologia, Barcelona (4); R. García-Boyero, Hospital General de Castelló (3); G. Debén, Complejo Hospitalario Juan Canalejo, Coruña (3); J. M. de Blas, Hospitales Universitarios Virgen del Rocío, Sevilla (3); F. J. Capote, Hospital Universitario Puerta del Mar, Cádiz (3); J. Rafecas, Hospital Universitario Dr. Peset, Valencia (2); C. Pederós, Complejo Hospitalario Xeral-Cies, Vigo (2); G. Ramírez, Complejo Hospitalario Virgen de la Victoria, Málaga (2); A. Llorente, Hospital Universitari de Tarragona Joan XXIII (2); A. León, Hospital General de Jerez de la Frontera (2); R. Martino, Hospital de la Santa Creu i Sant Pau, Barcelona (1); E. Martín, Hospital Juan Ramón Jiménez, Huelva (1); J. M. de Pablos, Hospital Universitario Virgen de las Nieves, Granada (1); J. Bargay, Hospital Son Llàtzer, Palma de Mallorca (1); M. López-Duarte, Hospital Universitario Marqués de Valdecilla, Santander (1).