Effect of Caspofungin vs Fluconazole Prophylaxis on Invasive Fungal Disease Among Children and Young Adults With Acute Myeloid Leukemia: A Randomized Clinical Trial

Fisher BT, Zaoutis T, Dvorak CC, Nieder M, Zerr D, Wingard JR, Callahan C, Villaluna D, Chen L, Dang H, Esbenshade AJ, Alexander S, Wiley JM, Sung L. Effect of Caspofungin vs Fluconazole Prophylaxis on Invasive Fungal Disease Among Children and Young Adults With Acute Myeloid Leukemia: A Randomized Clinical Trial. JAMA. 2019 Nov 5;322(17):1673-1681. doi: 10.1001/jama.2019.15702. PubMed PMID: 31688884; PubMed Central PMCID: PMC6865545.

In this randomized clinical trial, which was terminated early after enrolling 517 patients, the incidence of proven or probable invasive fungal disease was statistically significantly lower in the caspofungin group than in the fluconazole group (5-month cumulative incidence, 3.1% vs 7.2%). The findings suggest that caspofungin may be considered for prophylactic therapy against invasive fungal disease in children, adolescents, and young adults with acute myeloid leukemia.