title: Impact of risk stratification on the duration of caspofungin therapy for invasive fungal disease in acute leukemic patients.
abstract: OBJECTIVE
  We retrospectively analyzed 141 acute leukemia patients with unclassified invasive fungal disease episodes during chemotherapy to determine the optimum duration of antifungal treatment.
  
  
  METHODS
  Patients were divided into standard-risk and high-risk groups and treated with intravenous caspofungin for either 1 or 2 weeks, followed by oral voriconazole.
  
  
  RESULTS
  Favorable responses occurred in 75.9% of patients (107/141) overall. Although there were no significant differences in response rates between patients receiving 1 or 2 weeks in the standard-risk group (p = 0.12 and p = 0.19, respectively), in the high-risk group, response rates were significantly higher in the 2-week than the 1-week treatment group (p = 0.01 and p = 0.02, respectively).
  
  
  CONCLUSIONS
  The duration of caspofungin treatment for patients with unclassified invasive fungal diseases may be optimized by risk stratification.
authors.affiliation: Leukemia Diagnosis & Treatment Center, Institute of Hematology & Blood Disease Hospital, Chinese Academy of Medical Sciences & Peking Union of Medical College, Tianjin, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Li
authors.forename: Xingli
authors.initials: X
authors.lastname: Zhao
authors.forename: Benfa
authors.initials: B
authors.lastname: Gong
authors.forename: Yuntao
authors.initials: Y
authors.lastname: Liu
authors.forename: Shuning
authors.initials: S
authors.lastname: Wei
authors.forename: Guangji
authors.initials: G
authors.lastname: Zhang
authors.forename: Kaiqi
authors.initials: K
authors.lastname: Liu
authors.forename: Bingcheng
authors.initials: B
authors.lastname: Liu
authors.forename: Hui
authors.initials: H
authors.lastname: Wei
authors.forename: Ying
authors.initials: Y
authors.lastname: Wang
authors.forename: Dong
authors.initials: D
authors.lastname: Lin
authors.forename: Yingchang
authors.initials: Y
authors.lastname: Mi
authors.forename: Jianxiang
authors.initials: J
authors.lastname: Wang
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000008:administration & dosage*; D000077336:Caspofungin; D004359:Drug Therapy, Combination; D054714:Echinocandins / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007938:Leukemia / Q000150:complications*; D055666:Lipopeptides; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000188:drug therapy*; D012189:Retrospective Studies; D012306:Risk; D016896:Treatment Outcome; D065819:Voriconazole / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D000077336:Caspofungin; D065819:Voriconazole
keywords: acute; antifungal therapy; caspofungin; invasive fungal disease; leukemia; risk stratification; treatment duration