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The Outcome of Antifungal Prophylaxis with Posaconazole in Patients with Acute Myeloid Leukemia: A Single-Center Study
OBJECTIVE: Invasive fungal infections (IFIs) are a significant cause of morbidity and mortality among neutropenic patients undergoing chemotherapy for acute myeloid leukemia (AML) and stem cell transplantation. The aim of this study was to evaluate the real-life impact of posaconazole prophylaxis. M...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Galenos Publishing
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6256813/ https://www.ncbi.nlm.nih.gov/pubmed/30047484 http://dx.doi.org/10.4274/tjh.2017.0430 |
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author | Özkocaman, Vildan Özkalemkaş, Fahir Seyhan, Serdar Ener, Beyza Ursavaş, Ahmet Ersal, Tuba Kazak, Esra Demirdöğen, Ezgi Mıstık, Reşit Akalın, Halis |
author_facet | Özkocaman, Vildan Özkalemkaş, Fahir Seyhan, Serdar Ener, Beyza Ursavaş, Ahmet Ersal, Tuba Kazak, Esra Demirdöğen, Ezgi Mıstık, Reşit Akalın, Halis |
author_sort | Özkocaman, Vildan |
collection | PubMed |
description | OBJECTIVE: Invasive fungal infections (IFIs) are a significant cause of morbidity and mortality among neutropenic patients undergoing chemotherapy for acute myeloid leukemia (AML) and stem cell transplantation. The aim of this study was to evaluate the real-life impact of posaconazole prophylaxis. MATERIALS AND METHODS: Eighty-four adult patients were included with AML under remission induction chemotherapy and posaconazole prophylaxis. The 34 patients in the control group did not receive primary antifungal prophylaxis. The period between June 2006 and January 2009, when antifungal prophylaxis was not administered (control group), was retrospectively compared to the period between December 2010 and May 2012 when primary oral posaconazole prophylaxis was administered in similar conditions (posaconazole group) according to the use of antifungal agents for treatment, breakthrough infections, galactomannan performance, and the necessity for performing bronchoalveolar lavage (BAL) procedures. RESULTS: The two groups were compared according to the use of antifungal agents; progression to a different antifungal agent was found in 34/34 patients (100%) in the control group and in 9/84 patients (11%) in the posaconazole group (p<0.001). There were four breakthrough IFIs (4/84, 4.8%) in the posaconazole group and 34 IFIs in the control group (p<0.001). In addition, 15/34 patients (44%) in the control group required BAL compared to 11/84 patients (13%) in the posaconazole group (p<0.001). Posaconazole treatment was discontinued within 7-14 days in 7/84 patients (8.3%) due to poor oral compliance related to mucositis after chemotherapy. CONCLUSION: Posaconazole appears to be effective and well-tolerated protection against IFIs for AML patients. |
format | Online Article Text |
id | pubmed-6256813 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Galenos Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-62568132018-11-30 The Outcome of Antifungal Prophylaxis with Posaconazole in Patients with Acute Myeloid Leukemia: A Single-Center Study Özkocaman, Vildan Özkalemkaş, Fahir Seyhan, Serdar Ener, Beyza Ursavaş, Ahmet Ersal, Tuba Kazak, Esra Demirdöğen, Ezgi Mıstık, Reşit Akalın, Halis Turk J Haematol Original Research OBJECTIVE: Invasive fungal infections (IFIs) are a significant cause of morbidity and mortality among neutropenic patients undergoing chemotherapy for acute myeloid leukemia (AML) and stem cell transplantation. The aim of this study was to evaluate the real-life impact of posaconazole prophylaxis. MATERIALS AND METHODS: Eighty-four adult patients were included with AML under remission induction chemotherapy and posaconazole prophylaxis. The 34 patients in the control group did not receive primary antifungal prophylaxis. The period between June 2006 and January 2009, when antifungal prophylaxis was not administered (control group), was retrospectively compared to the period between December 2010 and May 2012 when primary oral posaconazole prophylaxis was administered in similar conditions (posaconazole group) according to the use of antifungal agents for treatment, breakthrough infections, galactomannan performance, and the necessity for performing bronchoalveolar lavage (BAL) procedures. RESULTS: The two groups were compared according to the use of antifungal agents; progression to a different antifungal agent was found in 34/34 patients (100%) in the control group and in 9/84 patients (11%) in the posaconazole group (p<0.001). There were four breakthrough IFIs (4/84, 4.8%) in the posaconazole group and 34 IFIs in the control group (p<0.001). In addition, 15/34 patients (44%) in the control group required BAL compared to 11/84 patients (13%) in the posaconazole group (p<0.001). Posaconazole treatment was discontinued within 7-14 days in 7/84 patients (8.3%) due to poor oral compliance related to mucositis after chemotherapy. CONCLUSION: Posaconazole appears to be effective and well-tolerated protection against IFIs for AML patients. Galenos Publishing 2018-11 2018-11-13 /pmc/articles/PMC6256813/ /pubmed/30047484 http://dx.doi.org/10.4274/tjh.2017.0430 Text en © Copyright 2018, Turkish Journal of Hematology, Published by Galenos Publishing. http://creativecommons.org/licenses/by/2.5/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Research Özkocaman, Vildan Özkalemkaş, Fahir Seyhan, Serdar Ener, Beyza Ursavaş, Ahmet Ersal, Tuba Kazak, Esra Demirdöğen, Ezgi Mıstık, Reşit Akalın, Halis The Outcome of Antifungal Prophylaxis with Posaconazole in Patients with Acute Myeloid Leukemia: A Single-Center Study |
title | The Outcome of Antifungal Prophylaxis with Posaconazole in Patients with Acute Myeloid Leukemia: A Single-Center Study |
title_full | The Outcome of Antifungal Prophylaxis with Posaconazole in Patients with Acute Myeloid Leukemia: A Single-Center Study |
title_fullStr | The Outcome of Antifungal Prophylaxis with Posaconazole in Patients with Acute Myeloid Leukemia: A Single-Center Study |
title_full_unstemmed | The Outcome of Antifungal Prophylaxis with Posaconazole in Patients with Acute Myeloid Leukemia: A Single-Center Study |
title_short | The Outcome of Antifungal Prophylaxis with Posaconazole in Patients with Acute Myeloid Leukemia: A Single-Center Study |
title_sort | outcome of antifungal prophylaxis with posaconazole in patients with acute myeloid leukemia: a single-center study |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6256813/ https://www.ncbi.nlm.nih.gov/pubmed/30047484 http://dx.doi.org/10.4274/tjh.2017.0430 |
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