Posaconazole in prophylaxis and salvage treatment of invasive fungal infections during neutropenia in pediatric patients with leukemia: a retrospective analysis
10.3760/cma.j.issn.2095-428X.2019.10.006
- VernacularTitle: 泊沙康唑预防或挽救性治疗儿童白血病粒细胞缺乏期侵袭性真菌感染的回顾性分析
- Author:
Lihua YU
1
;
Danna LIN
1
;
Yili WU
1
;
Xiaolan WANG
2
;
Li WU
1
;
Qiulei HU
1
;
Bin WANG
1
;
Lihua YANG
1
Author Information
1. Department of Pediatrics, Zhujiang Hospital of Southern Medical University, Guangzhou 510280, China
2. Department of Pediatrics, Foshan Women and Children′s Hospital, Foshan 528000, Guangdong Province, China
- Publication Type:Journal Article
- Keywords:
Posaconazole;
Leukemia;
Invasive fungal infection;
Neutropenia;
Child
- From:
Chinese Journal of Applied Clinical Pediatrics
2019;34(10):745-748
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the efficacy and safety of Posaconazole (Posa) in prophylaxis and salvage treatment of invasive fungal infections (IFI) during neutropenia in pediatric patients with leukemia.
Methods:A total of 18 pediatric patients (55 case-time) with leukemia in neutropenia stage receiving Posa treatment from December 2015 to August 2017 in Zhujiang Hospital of Southern Medical University, were analyzed retrospectively.Taking one induction chematherapy or one consolidation chemotherapy stage receiving Posa treatment was defined as 1 case-time.
Results:Out of 18 participants, 13 cases were patients with acute myeloid leukemia (AML) and 5 cases were patients with acute lymphocytic leukemia (ALL), including 36 males and 19 females.Median age of the participants was 7 years, ranged from 10 months to 14 years.Out of 55 case times, 45 of them were of primary prevention and the neutropenia periods ranged from 4 to 46 days, with the median of 15 days, and 93.33% of them were prevented from fungal infection.However, 3 of the 45 cases had sudden fungal infections and the Voriconazole was an effective treatment, and no one died.Six cases in this study experienced secondary prevention, and no patient experienced reinfection.The neutropenia terms of the 6 cases ranged from 10 to 17 days, with the median of 14 days.Four patients who suffered from Voriconazole and/or Carbophenol therapy failure received Posa as a rescue therapy and the response rate was 100%.None of patients had Posa intolerance due to severe adverse reaction and no Posa treatment-related grade Ⅱ toxic effects occurred.
Conclusions:Posa is an effective and safe therapy for pediatric patients with leukemia and IFI, and available for long-time usage.Serious adverse reaction is rare.
