Clinical investigation of reduced-dose voriconazole on primary prevention in invasive fungal disease after allogeneic hematopoietic stem cell transplantation.
- Author:
Zhixiang QIU
1
;
Hanyun REN
1
;
Xinan CEN
1
;
Jinping OU
1
;
Weilin XU
1
;
Mangju WANG
1
;
Lihong WANG
1
;
Yujun DONG
1
;
Yuan LI
1
;
Wei LIU
1
;
Yuhua SUN
1
;
Zeyin LIANG
1
;
Qian WANG
1
Author Information
- Publication Type:Journal Article
- MeSH: Administration, Intravenous; Adolescent; Adult; Antifungal Agents; administration & dosage; therapeutic use; Child; Child, Preschool; Female; Fluconazole; administration & dosage; therapeutic use; Follow-Up Studies; Hematopoietic Stem Cell Transplantation; adverse effects; Humans; Male; Middle Aged; Mycoses; etiology; prevention & control; Postoperative Complications; prevention & control; Treatment Outcome; Voriconazole; administration & dosage; therapeutic use; Young Adult
- From: Chinese Journal of Hematology 2014;35(7):577-580
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo investigate the efficacy and tolerability of intravenous voriconazole on primary prevention in invasive fungal disease (IFD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT).
METHODSAt the time of conditioning regimen, patients without IFD was intravenously administered with voriconazole at a dose of 100 mg two times per day until neutrophils greater than 0.5×10⁹/L. Patients treated with oral fluconazole, 200 mg per day, were control group. The incidence and risk factors of IFD and side effects of medicines were evaluated.
RESULTSOf the total 227 patients, 33 (14.54%) had IFD within 3 months after allo-HSCT. There was significant difference on overall survival between patients with or without IFD by Kaplan-Meier survival curve (P=0.029). Of the 83 cases with intravenous voriconazole, 7 cases occurred IFD (8.43%). In contrast, the incidence of IFD in control group was 18.06% (26 out of 144). There was remarkable difference between the two groups (P=0.048). But there was no significant difference on risk factors of IFD between the two groups. In addition, the incidence of liver function abnormalities between the two groups was no difference. The ratio of auditory hallucination and visual impairment induced by voriconazole was not high.
CONCLUSIONIntravenous voriconazole on primary prevention for IFD after allo-HSCT is much better than oral fluconazole with well tolerability and satisfactory efficacy.