Bridging antifungal prophylaxis with 50 mg or 100 mg micafungin in allogeneic stem cell transplantation : A retrospective analysis
© 2019 The Authors. European Journal of Haematology published by John Wiley & Sons Ltd..
OBJECTIVE: Fluconazole or posaconazole is a standard of care in antifungal prophylaxis for patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT). However, many patients need to interrupt standard prophylaxis due to intolerability, drug-drug interactions, or toxicity. Micafungin has come to prominence for these patients. However, the optimal biological dose of micafungin stays unclear.
METHODS: We retrospectively evaluated the efficacy of micafungin as antifungal prophylaxis in HSCT patients. Micafungin was applied as bridging in patients who were not eligible to receive oral posaconazole. Micafungin was either given at a dose of 100 mg or 50 mg SID.
RESULTS: A total of 173 patients received micafungin prophylaxis, 62 in the 100 mg and 111 in the 50 mg dose group. The incidence of probable or proven breakthrough IFDs during the observation period was one in the 100 mg and one in the 50 mg group. Fungal-free survival after 100 days was 98% and 99% (P = .842), and overall survival after 365 days was 60% and 63% (P = .8) respectively. In both groups, micafungin was well tolerated with no grade 3 or 4 toxicities.
CONCLUSION: In this retrospective analysis, which was not powered to detect non-inferiority, micafungin is effective and complements posaconazole as fungal prophylaxis in HSCT.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:104 |
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| Enthalten in: |
European journal of haematology - 104(2020), 4 vom: 06. Apr., Seite 291-298 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Rothe, Achim [VerfasserIn] |
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| Links: |
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| Themen: |
Antifungal Agents |
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| Anmerkungen: |
Date Completed 07.12.2020 Date Revised 14.12.2020 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1111/ejh.13372 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM30456902X |
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| 100 | 1 | |a Rothe, Achim |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Bridging antifungal prophylaxis with 50 mg or 100 mg micafungin in allogeneic stem cell transplantation |b A retrospective analysis |
| 264 | 1 | |c 2020 | |
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| 500 | |a Date Completed 07.12.2020 | ||
| 500 | |a Date Revised 14.12.2020 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2019 The Authors. European Journal of Haematology published by John Wiley & Sons Ltd. | ||
| 520 | |a OBJECTIVE: Fluconazole or posaconazole is a standard of care in antifungal prophylaxis for patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT). However, many patients need to interrupt standard prophylaxis due to intolerability, drug-drug interactions, or toxicity. Micafungin has come to prominence for these patients. However, the optimal biological dose of micafungin stays unclear | ||
| 520 | |a METHODS: We retrospectively evaluated the efficacy of micafungin as antifungal prophylaxis in HSCT patients. Micafungin was applied as bridging in patients who were not eligible to receive oral posaconazole. Micafungin was either given at a dose of 100 mg or 50 mg SID | ||
| 520 | |a RESULTS: A total of 173 patients received micafungin prophylaxis, 62 in the 100 mg and 111 in the 50 mg dose group. The incidence of probable or proven breakthrough IFDs during the observation period was one in the 100 mg and one in the 50 mg group. Fungal-free survival after 100 days was 98% and 99% (P = .842), and overall survival after 365 days was 60% and 63% (P = .8) respectively. In both groups, micafungin was well tolerated with no grade 3 or 4 toxicities | ||
| 520 | |a CONCLUSION: In this retrospective analysis, which was not powered to detect non-inferiority, micafungin is effective and complements posaconazole as fungal prophylaxis in HSCT | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a immunology and infectious diseases | |
| 650 | 4 | |a transplantation | |
| 650 | 7 | |a Antifungal Agents |2 NLM | |
| 650 | 7 | |a Micafungin |2 NLM | |
| 650 | 7 | |a R10H71BSWG |2 NLM | |
| 700 | 1 | |a Claßen, Annika |e verfasserin |4 aut | |
| 700 | 1 | |a Carney, Jonathan |e verfasserin |4 aut | |
| 700 | 1 | |a Hallek, Michael |e verfasserin |4 aut | |
| 700 | 1 | |a Mellinghoff, Sibylle C |e verfasserin |4 aut | |
| 700 | 1 | |a Scheid, Christoph |e verfasserin |4 aut | |
| 700 | 1 | |a Holtick, Udo |e verfasserin |4 aut | |
| 700 | 1 | |a von Bergwelt-Baildon, Michael |e verfasserin |4 aut | |
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