CORNELY OA, SIENIAWSKI M, BOHME A, KARTHAUS M, MARTINO R, REICHERT D, MASCHMEYER G, BUCHHEIDT D, SILLING G, SCHIEL X, KRUEGER W, GRATWOHL A, ULLMANN AJ, LOVENICH H, FATKENHEUER G; Interscience Conference on Antimicrobial Agents and Chemotherapy (42nd : 2002 : San Diego, Calif.).

Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2002 Sep 27-30; 42: abstract no. M-1235.

Univ, Koln, Germany.

BACKGROUND: With more successful treatment due to less toxic new antifungals, chemotherapy can now be resumed despite prior IFI. The need for SP has evolved, but analysis of its efficacy is lacking. METHODS: Forty-one tertiary centers (Spain, Switzerland, Austria, Poland, Germany) participate in this study. Pts with AML/ALL, recent proven/probable IFI, heading subsequent neutropenia were included. RESULTS: We included 69 patients: age 13-80, median 45y, 45% female, 86% AML. Prior proven IFI were 24 (34.8%) aspergillosis, 5 (7.2%) candidiasis, 3 (4.3%) mucormycosis, 1 geotrichosis, 1 other; probable IFI in involved lungs in 35 (50.7%) pts, liver/spleen in 4 (5.8%), sinus in 1. SP regimens comprised amphotericin B iv in 34 (49.3%), itraconazole in 29 (42%), voriconazole in 3 (4.3%), fluconazole in 10 (14.5%), caspofungin in 4 (5.8%), and none in 5 (7.2%) pts. Incidences of proven/probable/possible breakthrough IFI under SP among 34 amphotericin B pts were (4/5/5 = 48%), among 29 itraconazole pts (1/4/3 = 28%), and among all (6/9/7 = 32%). Proven breakthrough IFI were 4 aspergillosis, 2 candidiasis; probable IFI were 8 lung, 3 hepatosplenic; possible IFI were 7 pts. Death occurred in 11 (16%) pts and was attributable to IFI in 5 (7.3%) and to leukemia in 6 (8.7%). CONCLUSIONS: SP after proven/probable IFI is instituted frequently & with various regimens. Incidence of breakthrough secondary IFI and attributable mortality are high in this population. Prospective studies on SP are urgently warranted.

Publication Types:

• Meeting Abstracts

Keywords:

• Amphotericin B
• Antifungal Agents
• Aspergillosis
• Austria
• Biomedical Research
• Candidiasis
• Female
• Fluconazole
• Germany
• Hematologic Tests
• Hematology
• Humans
• Incidence
• Itraconazole
• Mycoses
• Neutropenia
• Peptides, Cyclic
• Poland
• Prospective Studies
• Pyrimidines
• Spain
• Switzerland
• Triazoles
• caspofungin
• prevention & control
• therapy
• voriconazole

Other ID:

• GWAIDS0027265

UI: 102266889

From Meeting Abstracts