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Post-Transplant Events

Efficacy of caspofungin as secondary prophylaxis in patients undergoing allogeneic stem cell transplantation with prior pulmonary and/or systemic fungal infection

Bone Marrow Transplantation volume 40, pages 245–249 (2007)Cite this article

Abstract

Transplanted patients with a history of invasive fungal infection (IFI) are at high risk of developing relapse and fatal complications. Eighteen patients affected by hematological malignancies and a previous IFI were submitted to allogeneic stem cell transplantation, using Caspofungin as a secondary prophylaxis. Patients had a probable or proven fungal infection and 16 had a pulmonary localization. No side effects were recorded during treatment with Caspofungin. Compared to pre-transplant evaluation, stability or improvement of the previous IFI was observed in 16 of the 18 patients at day 30, in 13 of the 15 evaluable patients at day 180 and in 11 of the 11 evaluable patients at day 360 post transplant. In particular, all the six patients with a proven fungal infection were alive, with a stable or improved IFI after 1 year from transplant. At a maximum follow-up of 31 months, eight patients died for disease progression or transplant-related complications, but only two had evidence of fungal progression. Secondary prophylaxis with Caspofungin may represent a suitable approach to limit IFI relapse or progression, allowing patients with hematological malignancies to adhere to the planned therapeutic program.

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Authors and Affiliations

  1. Department of Hematology, S Eugenio Hospital, Tor Vergata University, Rome, Italy

    P de Fabritiis, A Spagnoli & L Cupelli

  2. Transplant Unit, Santo Spirito Hospital, Pescara, Italy

    P Di Bartolomeo & S Santarone

  3. Department of Hematology, S Camillo Hospital, Rome, Italy

    A Locasciulli & I Majolino

  4. Department of Hematology, Policlinico Universitario, Tor Vergata University, Rome, Italy

    L Cudillo & A Picardi

  5. Department of Hematology, Ferrarotto Hospital, Catania, Italy

    G Milone & M Poidomani

  6. Department of Hematology, Le Molinette Hospital, Torino, Italy

    A Busca

  7. Department of Hematology, Cervello Hospital, Palermo, Italy

    R Scimè

  8. Department of Hematology ‘S Maria Nuova’ Hospital, Reggio Emilia, Italy

    A Bonini

  9. Department of Hematology, UCSC, Rome, Italy

    P Chiusolo

  10. Department of Hematology, Nuovo Ospedale Torrette, Ancona, Italy

    A Olivieri

  11. Department of Pharmacology, University of Firenze, Firenze, Italy

    S Fallani & A Novelli

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  1. P de Fabritiis
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  7. A Busca
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  10. A Bonini
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  11. L Cupelli
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  12. P Chiusolo
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  13. A Olivieri
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  14. S Santarone
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  15. M Poidomani
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  16. S Fallani
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  17. A Novelli
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  18. I Majolino
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Correspondence to P de Fabritiis.

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de Fabritiis, P., Spagnoli, A., Di Bartolomeo, P. et al. Efficacy of caspofungin as secondary prophylaxis in patients undergoing allogeneic stem cell transplantation with prior pulmonary and/or systemic fungal infection. Bone Marrow Transplant 40, 245–249 (2007). https://doi.org/10.1038/sj.bmt.1705720

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  • DOI: https://doi.org/10.1038/sj.bmt.1705720

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