MEDITERRANEAN JOURNAL OF HEMATOLOGY AND INFECTIOUS DISEASES www.mjhid.org ISSN 2035-3006
Original Articles
Outcome off Antifungal Combination Therapy for or Invasive Mold Infections in Hematological Patients iss Independent of the Chosen Combination Rafael Rojas1, José R. Molina1, Isidro Jarque2, Carmen Montes3, Josefina Serrano1, Jaime Sanz2, Juan Besalduch4, Enric Carreras5, José F. Tomas6, Luis Madero7, Daniel Rubio8, Eulogio Conde3, Miguel A. Sanz2 and Antonio Torres1. The Departments of Hematology and Stem Cell Transplantation Units of: 1 University Hospital Reina Sofia, Cordoba. Spain. 2 University Hospital La Fe, Valencia. Spain. 3 University Hospital Marqués de Valdecilla, Santander. Spain. 4 University Hospital Son Dureta, Palma de Mallorca. Spain. 5 University Hospital Clinic, Barcelona. na. Spain. 6 University Hospital MD Anderson, Madrid. Spain. 7 University Hospital al Niño Jesús, Madrid. Spain. 8 University Hospital Miguel Servet, Zaragoza. Spain. Correspondence to: Miguel A. Sanz, MD, PhD. Hematology Department, University Hospital La Fe Fe, Bulevar Sur s/n, 46026 Valencia. Spain. Tel/Fax /Fax number: 34-961 34 245 875. E-mail:
[email protected] Competing interests: The authors have declared that th no competing interests exist. Published: February 10, 2012 Received: January 19, 2012 Accepted: February 8, 2012 Mediterr J Hematol Infect Dis 2012, 4(1):: e2012011 e2012011, DOI 10.4084/MJHID.2012.011 This article is available from: http://www.mjhid.org/article/view/9832 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract. Invasive mold infection (IMI) remains a major cause of mortality in high-risk high hematological patients. The aim of this multicenter retrospective, observational study was to evaluate antifungal combination therapy (ACT) for proven and probable IMI in hematological patients. We analyzed 61 consecutive cases of proven (n=25) and probable probable (n=36) IMI treated with ACT collected from eight Spanish hospitals from January 2005 to December 2009. Causal pathogens were: Aspergillus spp (n=49), Zygomycetes (n=6), Fusarium spp (n=3), and Scedosporium spp (n=3). Patients were classified in three three groups according to the antifungal combination employed: Group A, liposomal amphotericin B (L-AmB) (L AmB) plus caspofungin (n=20); Group B, L LAmB plus a triazole (n=20), and Group C, voriconazole plus a candin (n=21). ACT was well tolerated with minimal adverse effects. Thirty-eight Thirty eight patients (62%) achieved a favorable response (35 complete). End of treatment and 12-week 12 week survival rates were 62% and 57% respectively, without statistical differences among groups. Granulocyte recovery was significantly related to favorable vorable response and survival (p
