Efficacy and Safety of Diagnostic-Driven Therapy for Invasive Fungal Disease in Patients with Myeloid Hematologic Malignancies.
10.19746/j.cnki.issn.1009-2137.2025.05.041
- Author:
Hui XIAO
1
;
Fan WU
1
;
Ying PAN
1
;
Fu-Run AN
1
;
Zhi-Min ZHAI
1
Author Information
1. Department of Hematology, The Second Hospital of Anhui Medical University, Hefei 230601, Anhui Province, China.
- Publication Type:Journal Article
- Keywords:
myeloid hematologic malignancies;
invasive fungal disease;
diagnostic-driven therapy;
caspofungin
- MeSH:
Humans;
Retrospective Studies;
Hematologic Neoplasms/complications*;
Antifungal Agents/therapeutic use*;
Voriconazole/therapeutic use*;
Caspofungin/therapeutic use*;
Invasive Fungal Infections/diagnosis*;
Male;
Female;
Mycoses/drug therapy*;
Middle Aged;
Treatment Outcome;
Aged;
Adult
- From:
Journal of Experimental Hematology
2025;33(5):1524-1528
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To investigate the efficacy and safety of diagnostic-driven therapy for invasive fungal disease(IFD) in patients with myeloid hematologic malignancies.
METHODS:A retrospective analysis was conducted on the clinical data of 91 patients with myeloid hematologic malignancies who received diagnostic-driven therapy for IFD at the Second Hospital of Anhui Medical University from January 1, 2020 to December 31, 2023. The patients were divided into two groups based on medication: 44 patients in the caspofungin group and 47 patients in the voriconazole group. The clinical efficacy and adverse reactions of the two groups were compared and analyzed.
RESULTS:The overall response rates in the caspofungin and voriconazole groups were 67.4% and 60.0%, respectively. Among patients who transitioned to diagnostic-driven therapy following prophylactic or empirical treatment with triazole antifungal agents, the response rate of the caspofungin group was significantly higher than that of the voriconazole group (76.9% vs 35.3%, P <0.05). A total of 9 patients in both groups experienced adverse reactions, and no grade III or higher adverse reactions occurred. The incidence of grade I-II adverse reactions in the caspofungin group was lower than in the voriconazole group (2.3% vs 17.0%, P <0.05).
CONCLUSION:In patients with myeloid hematologic malignancies, caspofungin and voriconazole demonstrate comparable clinical efficacy in diagnostic-driven therapy for IFD, but caspofungin is associated with a lower incidence of adverse reactions. Caspofungin exhibits significant effectiveness when initiating diagnostic-driven therapy after prophylactic or empirical treatment with broad-spectrum triazole antifungal agents.
