Outcomes of Antifungal Prophylaxis in High-Risk Haematological Patients (AML under Intensive Chemotherapy): The SAPHIR Prospective Multicentre Study
| Autor: | Christophe Padoin, Thomas Gastinne, Arnaud Pigneux, Jean-Pierre Gangneux, Mauricette Michallet, Patrice Ceballos, Regis Peffault de la Tour, Alexandra Kumichel, Emeline Saillio |
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| Přispěvatelé: | Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), CHU Pontchaillou [Rennes], CHU de la Martinique [Fort de France], Centre Léon Bérard [Lyon], Service de Neurologie [Lyon], CHU Lyon, MSD France, ClinSearch, Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Lapeyronie [Montpellier] (CHU), Centre hospitalier universitaire de Nantes (CHU Nantes), CHU Bordeaux [Bordeaux], Jonchère, Laurent, Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Institut National de la Santé et de la Recherche Médicale (INSERM)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université d'Angers (UA) |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
[SDV.MHEP.HEM] Life Sciences [q-bio]/Human health and pathology/Hematology
Microbiology (medical) Antifungal Posaconazole medicine.medical_specialty medicine.drug_class medicine.medical_treatment [SDV.CAN]Life Sciences [q-bio]/Cancer Plant Science Intensive chemotherapy Neutropenia Article 03 medical and health sciences 0302 clinical medicine [SDV.CAN] Life Sciences [q-bio]/Cancer [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases antifungal prophylaxis Internal medicine hemic and lymphatic diseases medicine haematological malignancies neutropenia 030212 general & internal medicine lcsh:QH301-705.5 neoplasms Ecology Evolution Behavior and Systematics 0303 health sciences Chemotherapy 030306 microbiology business.industry Incidence (epidemiology) Induction chemotherapy [SDV.MHEP.HEM]Life Sciences [q-bio]/Human health and pathology/Hematology medicine.disease 3. Good health invasive fungal disease Transplantation lcsh:Biology (General) [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie business medicine.drug |
| Zdroj: | Journal of Fungi Volume 6 Issue 4 Journal of Fungi, 2020, 6 (4), pp.281. ⟨10.3390/jof6040281⟩ Journal of Fungi, MDPI, 2020, 6 (4), pp.281. ⟨10.3390/jof6040281⟩ Journal of Fungi, Vol 6, Iss 281, p 281 (2020) |
| ISSN: | 2309-608X |
| DOI: | 10.3390/jof6040281 |
| Popis: | Antifungal prophylaxis (AFP) is recommended by international guidelines for patients with acute myeloid leukaemia (AML) undergoing induction chemotherapy and allogeneic hematopoietic cell transplantation. Nonetheless, treatment of breakthrough fungal infections remains challenging. This observational, prospective, multicentre, non-comparative study of patients undergoing myelosuppressive and intensive chemotherapy for AML who are at high-risk of invasive fungal diseases (IFDs), describes AFP management and outcomes for 404 patients (65.6% newly diagnosed and 73.3% chemotherapy naï ve). Ongoing chemotherapy started 1.0 ± 4.5 days before inclusion and represented induction therapy for 79% of participants. In 92.3% of patients, posaconazole was initially prescribed, and 8.2% of all patients underwent at least one treatment change after 17 ± 24 days, mainly due to medical conditions influencing AFP absorption (65%). The mean AFP period was 24 ± 32 days, 66.8% stopped their prophylaxis after the high-risk period and 31.2% switched to a non-prophylactic treatment (2/3 empirical, 1/3 pre-emptive/curative). Overall, 9/404 patients (2.2%) were diagnosed with probable or proven IFDs. During the follow-up, 94.3% showed no signs of infection. Altogether, 20 patients (5%) died, and three deaths (0.7%) were IFD-related. In conclusion, AFP was frequently prescribed and well tolerated by these AML patients, breakthrough infections incidence and IFD mortality were low and very few treatment changes were required. |
| Databáze: | OpenAIRE |
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