PMID- 16431856
OWN - NLM
STAT- MEDLINE
DCOM- 20060510
LR  - 20181203
IS  - 0305-7453 (Print)
IS  - 0305-7453 (Linking)
VI  - 57
IP  - 3
DP  - 2006 Mar
TI  - Treatment with caspofungin in immunocompromised paediatric patients: a 
      multicentre survey.
PG  - 527-35
AB  - OBJECTIVES: Although a paediatric dosage has not been established, caspofungin is 
      occasionally used in paediatric patients. We conducted a multicentre 
      retrospective survey to obtain data on immunocompromised paediatric patients 
      considered to require caspofungin therapy. METHODS: The survey identified 64 
      patients (median age: 11.5 years; 25 females, 39 males) with haematological 
      malignancies (48), marrow failure (9), solid tumours (3), haematological 
      disorders (2) and congenital immunodeficiency (2) who received caspofungin for 
      proven (17), probable (14) and possible (17) invasive fungal infections or 
      empirically (16). Caspofungin was administered until intolerance or maximum 
      efficacy at dosages individually determined by the responsible physician for 
      refractory infection (38), intolerance of other agents (10) or as best 
      therapeutic option (16). RESULTS: The 64 patients received caspofungin for a 
      median of 37 days (range 3-218) as single agent (20) or in combination (44). The 
      median daily maintenance dosage was 1.07 mg/kg (95% CI 1.09-1.35; range 
      0.40-2.92) or 34.3 mg/m2 (95% CI 32.3-37.3; range 16.3-57.5). In none of the 
      patients was therapy discontinued due to adverse events (AEs). Clinical AEs were 
      mild to moderate and observed in 34 patients (53.1%). While mean glutamate 
      pyruvate transaminase and glutamate oxalate transaminase values were slightly (P 
      < 0.005) higher at the end of treatment (EOT), serum bilirubin, alkaline 
      phosphatase and creatinine values were not different from baseline. Complete 
      responses, partial responses or stabilization were observed in 5/7/3 of 17 
      patients with proven, in 3/4/3 of 14 patients with probable and in 7/6/1 of 15 
      evaluable patients with possible invasive infections. Thirteen of 16 patients on 
      empirical therapy completed without breakthrough infection. Overall survival was 
      75% at the EOT and 70% at 3 months post-EOT, respectively. CONCLUSIONS: 
      Caspofungin displayed favourable safety and tolerance and may have useful 
      antifungal efficacy in severely immunocompromised paediatric patients.
FAU - Groll, Andreas H
AU  - Groll AH
AD  - Infectious Disease Research Program, Center for Bone Marrow Transplantation and 
      Department of Paediatric Haematology/Oncology, Children's University Hospital, 
      Muenster, Germany. grollan@ukmuenster.de
FAU - Attarbaschi, Andishe
AU  - Attarbaschi A
FAU - Schuster, Friedhelm R
AU  - Schuster FR
FAU - Herzog, Nadine
AU  - Herzog N
FAU - Grigull, Lorenz
AU  - Grigull L
FAU - Dworzak, Michael N
AU  - Dworzak MN
FAU - Beutel, Karin
AU  - Beutel K
FAU - Laws, Hans-Jurgen
AU  - Laws HJ
FAU - Lehrnbecher, Thomas
AU  - Lehrnbecher T
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20060123
PL  - England
TA  - J Antimicrob Chemother
JT  - The Journal of antimicrobial chemotherapy
JID - 7513617
RN  - 0 (Antifungal Agents)
RN  - 0 (Echinocandins)
RN  - 0 (Lipopeptides)
RN  - 0 (Peptides, Cyclic)
RN  - F0XDI6ZL63 (Caspofungin)
SB  - IM
MH  - Adolescent
MH  - Antifungal Agents/adverse effects/*therapeutic use
MH  - Caspofungin
MH  - Child
MH  - Child, Preschool
MH  - Echinocandins
MH  - Female
MH  - Humans
MH  - Immunocompromised Host
MH  - Infant
MH  - Lipopeptides
MH  - Male
MH  - Mycoses/drug therapy
MH  - Peptides, Cyclic/adverse effects/*therapeutic use
MH  - Retrospective Studies
EDAT- 2006/01/25 09:00
MHDA- 2006/05/11 09:00
CRDT- 2006/01/25 09:00
PHST- 2006/01/25 09:00 [pubmed]
PHST- 2006/05/11 09:00 [medline]
PHST- 2006/01/25 09:00 [entrez]
AID - dkl009 [pii]
AID - 10.1093/jac/dkl009 [doi]
PST - ppublish
SO  - J Antimicrob Chemother. 2006 Mar;57(3):527-35. doi: 10.1093/jac/dkl009. Epub 2006 
      Jan 23.