Posaconazole as primary prevention of fungal infection in intensive immunosuppressive therapy for severe aplastic anemia
10.3760/cma.j.issn.0253-2727.2018.02.010
- VernacularTitle: 泊沙康唑在重型再生障碍性贫血强化免疫抑制治疗初级预防真菌感染中的应用
- Author:
Miao CHEN
1
;
Junling ZHUANG
;
Minghui DUAN
;
Wei ZHANG
;
Jian LI
;
Tienan ZHU
;
Huacong CAI
;
Xinxin CAO
;
Jun FENG
;
Chen YANG
;
Yan ZHANG
;
Lu ZHANG
;
Daobin ZHOU
;
Bing HAN
Author Information
1. Department of Hematology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100730, China
- Publication Type:Journal Article
- Keywords:
Anemia, aplastic;
Immunosuppressive therapy;
Posaconazole
- From:
Chinese Journal of Hematology
2018;39(2):128-131
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To Evaluate the efficacy and safety of posaconazole as primary prevention of invasive fungal disease (IFD) in patients with severe aplastic anemia (SAA) treated with anti-thymus/lymphocyte immunoglobulin (ATG/ALG) combined with cyclosporine intensive immunosuppressive therapy (IST).
Methods:A retrospective analysis of clinical data of 58 SAA patients who received IST of anti-thymocyte immunoglobulin combining cyclosporine and antifungal prophylaxis during April 2013 to May 2017 in Peking Union Medical College Hospital was performed. The patients were divided into posaconazole prophylaxis group and the control group (itraconazole or fluconazole). The disease characteristics, IFD prevention effect and adverse drug reaction, curative effect and prognosis of the two groups were compared.
Results:Posaconazole was used to prevent fungal infection in 20 patients. The other 38 patients were used as the control group. Retrospective analysis showed comparable characteristics (gender, age, disease severity, etiology, interval between the onset of disease to treatment, ATG/ALG type) of both groups. The incidence of IFD were 0 and 15.8% in posaconazole prophylaxis group and the control group, respectively (P=0.084). In the control group, there were 6 cases diagnosed as IFD. Of them, 2 were confirmed, 2 suspected and 2 not identified. Five of the 6 cases were pulmonary infection, 1 bloodstream infections. Of the 6 IFD cases, 5 were very severe aplastic anemia (VSAA). There was no obvious adverse reaction in posaconazole prophylaxis group.
Conclusion:Posaconazole is safe and effective for primary prevention of fungal infection of SAA patients receiving IST, especially for the VSAA.
