Blood Res.  2017 Sep;52(3):167-173. 10.5045/br.2017.52.3.167.

Voriconazole plus caspofungin for treatment of invasive fungal infection in children with acute leukemia

• Lee KH
• Lim YT
• Hah JO
• Kim YK
• Lee CH
• Lee JM

• KMID: 2390978
• DOI: http://doi.org/10.5045/br.2017.52.3.167

Abstract

BACKGROUND
Invasive fungal infections (IFIs) are a life-threatening problem in immunocompromised patients. Despite timely diagnosis and appropriate antifungal therapy, clinical outcomes of IFIs remain unsatisfactory, necessitating treatment with a combination of antifungal agents. Therefore, childhood leukemic patients treated with voriconazole plus caspofungin were evaluated for the safety and efficacy of the combination antifungal therapy to treat IFIs.
METHODS
In this retrospective study, medical records were retrieved for patients admitted to the Pediatric Department of Yeungnam University Hospital, Daegu, South Korea, between April 2009 and May 2013. Medical records of 22 patients were analyzed.
RESULTS
Of the 22 patients studied, nine (41%) had been diagnosed with probable IFI, and 13 (59%) with possible IFI. All patients, except one, were already receiving antifungal monotherapy for the treatment of neutropenic fever. After a diagnosis of IFI was confirmed, antifungal monotherapy was replaced with combination therapy. The study's overall response rate was 90.9%, with complete responses in 86.3% of the patients. Two patients experienced a side effect of a small increase in liver enzyme levels.
CONCLUSION
Voriconazole plus caspofungin combination therapy is an effective and safe treatment for serious IFI in pediatric patients with acute leukemia.

Keyword

Antifungal agent; Aspergillosis; Caspofungin; Echinocandins; Invasive fungal infections; Voriconazole

MeSH Terms

Antifungal Agents
Aspergillosis
Child*
Daegu
Diagnosis
Echinocandins
Fever
Humans
Immunocompromised Host
Korea
Leukemia*
Liver
Medical Records
Retrospective Studies
Voriconazole*
Antifungal Agents
Echinocandins
Voriconazole

Figure

• 

  Fig. 1 The 100-day survival rate after initiation of combination therapy was 90.9%.

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