A prospective randomized trial of itraconazole vs fluconazole for the prevention of fungal infections in patients with acute leukemia and hematopoietic stem cell transplant recipients
| Autor: | Hannah Sprecher, N. Benyamini, Jacob M. Rowe, Tsila Zuckerman, N Dally, Nuhad Haddad, Ada Tamir, L Akria, A Gorelik, Ilana Oren, Eldad J. Dann, R. Fineman |
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| Rok vydání: | 2006 |
| Předmět: |
Adult
Male medicine.medical_specialty Antifungal Agents Neutropenia Adolescent Itraconazole medicine.medical_treatment Hematopoietic stem cell transplantation Aspergillosis Drug Administration Schedule Predictive Value of Tests Risk Factors Amphotericin B Internal medicine medicine Humans Transplantation Homologous Prospective Studies Fluconazole Mycosis Aged Transplantation Acute leukemia Leukemia business.industry Hematopoietic Stem Cell Transplantation Hematology Middle Aged medicine.disease Surgery Treatment Outcome Acute Disease Drug Therapy Combination Female business medicine.drug |
| Zdroj: | Bone marrow transplantation. 38(2) |
| ISSN: | 0268-3369 |
| Popis: | Fluconazole antifungal prophylaxis is standard care in allogeneic hematopoietic stem cell transplant (HSCT) recipients, but this drug lacks anti-Aspergillus activity, the primary cause of invasive fungal infection (IFI) in many transplantation centers. We performed a randomized trial to compare itraconazole vs fluconazole, for prevention of IFIs in patients with acute leukemia (AL) and HSCT recipients. One hundred and ninety-five patients were randomly assigned to either fluconazole or itraconazole antifungal prophylaxis, after stratification into high-risk and low-risk groups. Antifungal prophylaxis was started at the beginning of chemotherapy and continued until resolution of neutropenia, or until amphotericin B treatment was started. IFI occurred in 11 (11%) of itraconazole, and in 12 (12%) fluconazole recipients. Invasive candidiasis (IC) developed in two (2%) itraconazole and one (1%) fluconazole recipients, while invasive aspergillosis (IA) developed in nine (9%) itraconazole and 11(11%) fluconazole recipients. There was no difference in the incidence of total IFI, IC and IA between the two study arms. However, there was a nonsignificant trend towards reduced mortality among patients who developed IA while receiving itraconazole prophylaxis (3/9=33% vs 8/11=73%, P=0.095). |
| Databáze: | OpenAIRE |
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