Efficacy of caspofungin and itraconazole as secondary antifungal prophylaxis: analysis of data from a multinational case registry

The impact of prior invasive mold infections in leukemia patients who undergo allo-SCT in the era of triazole-based secondary prophylaxis

“…4 In addition, other investigators described conflicting results about the efficacy of secondary prophylaxis with echinocandins with a wide range of IMI relapse (11-32%). 6,8 Interestingly, in our study, we observed a relatively low rate of breakthrough IMIs (14%) and no IMI-attributable mortality in a corresponding patient population. Of note, 93% of our patients received a second generation triazole as secondary prophylaxis.…”

“…Most of the previous studies regarding secondary prophylaxis in patients with hematological malignancies are retrospective and include small heterogenous patients' populations, with various IMI classifications and different responses to antifungal treatment before HSCT. [2][3][4][5][6][7][8] Nonetheless, studies in which secondary prophylaxis was amphotericin B or first-generation triazoles reported commonly significant rates of relapsed IMIs (29-33%) and associated mortality rates (88%) in patients with hematological malignancies and histories of IMIs before allogeneic HSCT; 2-4 of note, liposomal amphotericin B was also shown to be associated with a high rate of kidney injury (36%). 4 In addition, other investigators described conflicting results about the efficacy of secondary prophylaxis with echinocandins with a wide range of IMI relapse (11-32%).…”

Secondary Antifungal Prophylaxis in Pediatric Hematopoietic Stem Cell Transplants

“…Caspofungin and liposomal amphotericin B can be safely used as SAP. 13,32,33 In a pediatric study evaluating amphotericin B and voriconazole, unless chronic GVHD, relapse of leukemia, or graft failure occurs, antifungal prophylaxis with aforementioned agents was found to be efficient. 13 In our study, the limiting role of hypokalemia in patients receiving long-term amphotericin B was notable in 3 patients; yet SAP with amphotericin B or caspofungin resulted with no recurrence of IFI that occurred before HSCT.…”

Current Role of Echinocandins in the Management of Invasive Aspergillosis

“…Finally, two other retrospective studies reported on the use of caspofungin as secondary prophylaxis in patients with IFI undergoing further chemotherapy or HSCT transplant, with a very different rate of observed fungal progression: 12% (2 of 17 cases of aspergillosis) and 29% of all IFIs [48,49]. In conclusion, both caspofungin and micafungin might be useful in preventing IFIs during high risk periods, as they are active against both Candida and Aspergillus.…”