卡泊芬净治疗中性粒细胞减少症伴发热患者9例分析

目的观察卡泊芬净治疗白血病患儿中性粒细胞减少症伴发热的疗效和安全性。方法9例白血病合并中性粒细胞减少症，伴发热，疑为侵袭性真菌感染，使用卡泊芬净首次剂量70mg·m^-2·d^-1，维持剂量50mg·m^-2·d^-1。其中4例合用脂质体两性霉素B2mg·m^-1·d^-1；持续治疗15～40d；观察用药前后不同时间患儿临床症状、体征，肝。肾功能、电解质和胸部CT的变化。结果卡泊芬净治疗I临床总有效率为88．8％，各种不良反应的发生率为11．1％，联合用药的起效快，疗程短。结论卡泊芬净治疗9例患儿有效率高，未发现明显不良反应，是治疗白血病患儿发热伴中性粒细胞减少症的的一种选择。

Nine cases of febrile neutropenia in leukemia patients:outcome of caspofungin treatment

Objective To analyze the efficacy and safety of caspofungin treatment for 9 cases of febrile neutropenia in children with leukemia. Methods Nine children with leukemia complicated with febrile neutropenia, probably due to invasive fungal infection, were given caspofungin, first dose 70mg·m^-2·d^-1 , followed by maintenance dose 50 mg·m^-2·d^-1 for 15-40 days. Four children were given caspofungin plus amphotericin B 2 mg·m^-1·d^-1. The clinical symptoms and signs, hepatic and renal function tests, the results of electrolytes and chest CT scan were reviewed at different time points. Results The overall clinical efficacy rate of caspofungin was 88.8 %. The incidence of various adverse events was 11. 1%. Combination therapy showed rapid response to therapy and shorter treatment duration. Conclusions Caspofungin therapy provides high efficacy and low toxicity in these 9 children. Caspofungin therapy is a good attempt for treatment of febrile neutropenia in leukemia children.