Caspofungin Acetate in Treating Children With Fever and Neutropenia

Inclusion Criteria

• •DISEASE CHARACTERISTICS:
• •Immunocompromised with one or more of the following conditions:
• •* Leukemia, lymphoma, or other cancer
• •* Underwent bone marrow or peripheral blood stem cell transplantation
• •* Aplastic anemia
• •Planned chemotherapy likely to incur more than 10 days of neutropenia
• •Absolute neutrophil count no greater than 500/mm\^3 AND at least 1 recorded fever over 38.0 ° C within 24 hours of study
• •No proven invasive fungal infection at time of study entry
• •* Superficial fungal infection (e.g., cutaneous fungal infection, thrush, or candidal vaginitis) treatable with topical antifungals allowed
• •PATIENT CHARACTERISTICS:
• •Age:
• •2 to 17
• •Performance status:
• •Not specified
• •Life expectancy:
• •At least 5 days
• •Hematopoietic:
• •See Disease Characteristics
• •Hemodynamically stable with no hemodynamic compromise
• •Hepatic:
• •AST or ALT no greater than 3 times upper limit of normal (ULN)
• •Alkaline phosphatase no greater than 5 times ULN (unless related to bony metastases or other suspected bony processes)
• •INR no greater than 1.6 (4.0 if receiving anticoagulants)
• •No acute hepatitis or cirrhosis
• •Renal:
• •Not specified
• •Other:
• •Functioning central venous catheter in place
• •No other condition or concurrent illness that would preclude study
• •No prior allergy, hypersensitivity, or serious reaction to echinocandin antifungals
• •HIV negative
• •Not pregnant or nursing
• •Negative pregnancy test
• •Fertile patients must use effective contraception other than or in addition to oral contraceptives
• •PRIOR CONCURRENT THERAPY:
• •Biologic therapy:
• •See Disease Characteristics
• •Chemotherapy:
• •See Disease Characteristics
• •Endocrine therapy:
• •Not specified
• •Radiotherapy:
• •Not specified
• •Surgery:
• •Not specified
• •Other:
• •No prior enrollment into this study
• •No more than 48 hours since prior parenteral systemic antibacterial therapy for fever and neutropenia
• •At least 14 days since prior investigational antibiotic or antifungal drugs
• •Concurrent topical antifungals (i.e., nystatin and/or azole formulations) for a superficial fungal infection allowed
• •No other concurrent investigational drugs, including antibiotics or antifungals
• •No concurrent rifampin, cyclosporine, phenytoin, carbamazapine, phenobarbital, or other antifungal treatments (except fluconazole)