{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T01:54:52Z","timestamp":1777859692730,"version":"3.51.4"},"reference-count":30,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2013,12,23]],"date-time":"2013-12-23T00:00:00Z","timestamp":1387756800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Pharmacy Practice"],"published-print":{"date-parts":[[2015,4]]},"abstract":"<jats:p>The antifungal activity of echinocandins is concentration dependent. Previously, we demonstrated that high-dose caspofungin (HD-CSP; 100 mg daily) was well tolerated in 34 immunosuppressed patients with cancer and may have favorably influenced outcomes. We retrospectively assessed all 91 patients in whom HD-CSP was given for the treatment of invasive fungal disease (IFD). The median number of doses was 18.5 \u00b1 21.5, and in 8 (9%) patients more than 40 doses were given. Most (62%) of the patients had leukemia. A total of 45 (49%) patients had undergone stem cell transplantation; 80% received allogeneic grafts and 47% had graft-versus-host disease. High-dose corticosteroids were given during antifungal therapy in 26 (29%) patients. In all, 8 (9%) patients had new elevation in serum bilirubin during HD-CSP therapy; normalization occurred after voriconazole and HD-CSP were discontinued in 4 patients each. No other short-term or delayed adverse events were observed. In all, 40 (44%) patients died of IFD. High-dose corticosteroids during HD-CSP (odds ratio [OR] 8, 95% confidence interval [CI] 2.1-30.4; P &lt; .002) and starting HD-CSP in the critical care unit (OR 67.5, 95% CI 5.25-868.9; P &lt; .001) were associated with death from fungal disease. Prolonged HD-CSP therapy was well tolerated. Drug-induced hyperbilirubinemia may pose a potential limitation for continued HD-CSP use in highly susceptible patients with hematologic neoplasms and stem cell transplantation.<\/jats:p>","DOI":"10.1177\/0897190013515927","type":"journal-article","created":{"date-parts":[[2013,12,23]],"date-time":"2013-12-23T23:16:03Z","timestamp":1387840563000},"page":"175-182","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":12,"title":["High-Dose Caspofungin as a Component of Combination Antifungal Therapy in 91 Patients With Neoplastic Diseases and Hematopoietic Stem Cell Transplantation"],"prefix":"10.1177","volume":"28","author":[{"given":"Amar","family":"Safdar","sequence":"first","affiliation":[{"name":"Department of Medicine, NYU Langone Medical Center, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gilhen","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Infection Control and Employee Health, University of Texas M. D. Anderson Cancer Center, Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorge","family":"Zuniga","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Infection Control and Employee Health, University of Texas M. D. Anderson Cancer Center, Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fadi","family":"Al Akhrass","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Infection Control and Employee Health, University of Texas M. D. Anderson Cancer Center, Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anupam","family":"Pande","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Infection Control and Employee Health, University of Texas M. D. Anderson Cancer Center, Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2013,12,23]]},"reference":[{"key":"bibr1-0897190013515927","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2009.325"},{"key":"bibr2-0897190013515927","doi-asserted-by":"publisher","DOI":"10.1086\/424465"},{"key":"bibr3-0897190013515927","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1705559"},{"key":"bibr4-0897190013515927","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.45.2.596-600.2001"},{"key":"bibr5-0897190013515927","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.48.4.1272-1280.2004"},{"key":"bibr6-0897190013515927","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.46.3.739-745.2002"},{"key":"bibr7-0897190013515927","doi-asserted-by":"publisher","DOI":"10.1086\/598933"},{"key":"bibr8-0897190013515927","volume-title":"Medically Important Fungi: a Guide to Identification","author":"Larone D","year":"1995"},{"key":"bibr9-0897190013515927","doi-asserted-by":"publisher","DOI":"10.1086\/588660"},{"key":"bibr10-0897190013515927","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.20262"},{"key":"bibr11-0897190013515927","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-198510000-00009"},{"key":"bibr12-0897190013515927","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2009.334"},{"key":"bibr13-0897190013515927","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.11479"},{"key":"bibr14-0897190013515927","doi-asserted-by":"publisher","DOI":"10.1038\/sj.leu.2405065"},{"key":"bibr15-0897190013515927","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2004.10.006"},{"key":"bibr16-0897190013515927","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00854-09"},{"key":"bibr17-0897190013515927","doi-asserted-by":"publisher","DOI":"10.1086\/589305"},{"key":"bibr18-0897190013515927","doi-asserted-by":"publisher","DOI":"10.1371\/journal.ppat.0020035"},{"key":"bibr19-0897190013515927","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00536-07"},{"key":"bibr20-0897190013515927","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01366-12"},{"key":"bibr21-0897190013515927","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01554-09"},{"key":"bibr22-0897190013515927","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.49.9.3697-3701.2005"},{"key":"bibr23-0897190013515927","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00425-10"},{"key":"bibr24-0897190013515927","doi-asserted-by":"publisher","DOI":"10.1086\/423380"},{"key":"bibr25-0897190013515927","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.23109"},{"key":"bibr26-0897190013515927","doi-asserted-by":"publisher","DOI":"10.1159\/000342121"},{"key":"bibr27-0897190013515927","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.21929"},{"key":"bibr28-0897190013515927","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.20710"},{"key":"bibr29-0897190013515927","doi-asserted-by":"publisher","DOI":"10.1007\/s12281-010-0006-x"},{"key":"bibr30-0897190013515927","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cit187"}],"container-title":["Journal of Pharmacy Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0897190013515927","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0897190013515927","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0897190013515927","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:35:47Z","timestamp":1777509347000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0897190013515927"}},"subtitle":["A Critical Review of Short-Term and Long-Term Adverse Events"],"short-title":[],"issued":{"date-parts":[[2013,12,23]]},"references-count":30,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2015,4]]}},"alternative-id":["10.1177\/0897190013515927"],"URL":"https:\/\/doi.org\/10.1177\/0897190013515927","relation":{},"ISSN":["0897-1900","1531-1937"],"issn-type":[{"value":"0897-1900","type":"print"},{"value":"1531-1937","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,12,23]]}}}