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Administration of micafungin as prophylactic antifungal therapy in patients undergoing allogeneic stem cell transplantation

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Title: Administration of micafungin as prophylactic antifungal therapy in patients undergoing allogeneic stem cell transplantation
Authors: Hashino, Satoshi Browse this author →KAKEN DB
Morita, Lena Browse this author
Takahata, Mutsumi Browse this author
Onozawa, Masahiro Browse this author
Nakagawa, Masao Browse this author
Kawamura, Takahito Browse this author
Fujisawa, Fumie Browse this author
Kahata, Kaoru Browse this author
Izumiyama, Koh Browse this author
Yonezumi, Masakatsu Browse this author
Chiba, Koji Browse this author
Kondo, Takeshi Browse this author →KAKEN DB
Asaka, Masahiro Browse this author
Keywords: invasive fungal infection
micafungin
fluconazole
allogeneic stem cell transplantation
Issue Date: Jan-2008
Publisher: Springer
Journal Title: International Journal of Hematology
Volume: 87
Issue: 1
Start Page: 91
End Page: 97
Publisher DOI: 10.1007/s12185-007-0011-1
PMID: 18224421
Abstract: Objective: Invasive fungal infection is one of the major causes of death in neutropenic patients undergoing allogeneic stem cell transplantation (SCT). Although prophylactic antifungal therapy with fluconazole (FLCZ) has become the standard care for these patients, there remains a need for more effective and cost-beneficial alternative drugs. Patients and Methods: We conducted a prospective study to evaluate the usefulness of the administration of micafungin (MCFG) as a prophylactic antifungal therapy for patients undergoing allogeneic SCT. The results were compared with previous data for patients who had received FLCZ. Results: A total of 44 patients who underwent allogeneic SCT were enrolled in the study. Data from 29 patients who received allogeneic SCT using prophylactic FLCZ before this study were used as historical control data. Underlying diseases included acute leukemia (n=16), non-Hodgkin’s lymphoma (n=11), myelodysplastic syndrome (n=6), and others (n=11) in the MCFG group and acute leukemia (n=18), chronic myelogenous leukemia (n=6), and others (n=5) in the FLCZ group. The median durations of administration of MCFG and FLCZ were 36 and 34 days, respectively. Prophylactic success, defined as the absence of proven, probable, and possible invasive fungal infection (IFI) until the end of prophylactic therapy was achieved in 36 (87.8%) of the 41 evaluated patients in the MCFG group and in 65.5% of the patients in the FLCZ group (p=0.038). No patients in the MCFG group showed proven or probable IFI, whereas proven or probable IFI was observed in 3 patients in the FLCZ group. Four patients in the MCFG group required dose escalation due to febrile neutropenia. Although one patient in the MCFG group required the discontinuation of MCFG due to allergic skin eruption (grade 2), none of the other patients in either group required dose reduction due to adverse effects. Conclusions: Although the study design was not a prospective randomized trial, our results indicate that the administration of MCFG at a daily dose of 100 mg is promising for prophylactic antifungal therapy in patients undergoing allogeneic SCT.
Rights: The original publication is available at www.springerlink.com
Relation: http://www.springerlink.com
Type: article (author version)
URI: http://hdl.handle.net/2115/32747
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 橋野 聡

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