TY - JOUR
T1 - A prospective, randomized study of empirical antifungal therapy for the treatment of chemotherapy-induced febrile neutropenia in children
AU - Caselli, Désirée
AU - Cesaro, Simone
AU - Ziino, Ottavio
AU - Ragusa, Pietro
AU - Pontillo, Alfredo
AU - Pegoraro, Anna
AU - Santoro, Nicola
AU - Zanazzo, Giulio
AU - Poggi, Vincenzo
AU - Giacchino, Mareva
AU - Livadiotti, Susanna
AU - Melchionda, Fraia
AU - Chiodi, Marcello
AU - Aricò, Maurizio
PY - 2012/7
Y1 - 2012/7
N2 - Given that the rationale for empirical antifungal therapy in neutropenic children is limited and based on adult patient data, we performed a prospective, randomized, controlled trial that evaluated 110 neutropenic children with persistent fever. Those at high risk for invasive fungal infections (IFI) received caspofungin (Arm C) or liposomal amphotericinB (Arm B); those with a lower risk were randomized to receive Arm B, C, or no antifungal treatment (Arm A). Complete response to empirical antifungal therapy was achieved in 90/104 patients (86·5%): 48/56 at high risk (85·7%) [88·0% in Arm B; 83·9% in Arm C (P = 0·72)], and 42/48 at low risk (87·5%) [87·5% in control Arm A, 80·0% Arm B, 94·1% Arm C; (P = 0·41)]. None of the variables tested by multiple logistic regression analysis showed a significant effect on the probability to achieve complete response. IFI was diagnosed in nine patients (8·2%, 95% confidence interval, 3·8-15·0). This randomized controlled study showed that empirical antifungal therapy was of no advantage in terms of survival without fever and IFI in patients aged
AB - Given that the rationale for empirical antifungal therapy in neutropenic children is limited and based on adult patient data, we performed a prospective, randomized, controlled trial that evaluated 110 neutropenic children with persistent fever. Those at high risk for invasive fungal infections (IFI) received caspofungin (Arm C) or liposomal amphotericinB (Arm B); those with a lower risk were randomized to receive Arm B, C, or no antifungal treatment (Arm A). Complete response to empirical antifungal therapy was achieved in 90/104 patients (86·5%): 48/56 at high risk (85·7%) [88·0% in Arm B; 83·9% in Arm C (P = 0·72)], and 42/48 at low risk (87·5%) [87·5% in control Arm A, 80·0% Arm B, 94·1% Arm C; (P = 0·41)]. None of the variables tested by multiple logistic regression analysis showed a significant effect on the probability to achieve complete response. IFI was diagnosed in nine patients (8·2%, 95% confidence interval, 3·8-15·0). This randomized controlled study showed that empirical antifungal therapy was of no advantage in terms of survival without fever and IFI in patients aged
KW - Cancer
KW - Children
KW - Empirical antifungal therapy
UR - http://www.scopus.com/inward/record.url?scp=84863450308&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84863450308&partnerID=8YFLogxK
U2 - 10.1111/j.1365-2141.2012.09156.x
DO - 10.1111/j.1365-2141.2012.09156.x
M3 - Article
C2 - 22571507
AN - SCOPUS:84863450308
VL - 158
SP - 249
EP - 255
JO - British Journal of Haematology
JF - British Journal of Haematology
SN - 0007-1048
IS - 2
ER -