Micafungin as prophylaxis of invasive fungal infection in patients undergoing haematopoietic stem cell transplantation
Background: Invasive fungal infection (IFI) such as candidiasis and mold infections cause signi64257; cant morbidity and mortality in hematopoietic stem cell transplantation (HSCT). Although prophylactic antifungal therapy with 64258; uconazole has become the standard care for these patients, it has been associated with the emergence of 64258; uconazole-resistant Candida infections. Additionally, 64258; uconazole is not reliably effective against invasive aspergillosis. Methods: Between January 2010 and September 2011, We conducted a prospective study to evaluate the usefulness of the administration of micafungin (MycamineÂ®), a class of echinocandin, as a prophylactic antifungal therapy for patients undergoing HSCT. Micafungin was started at a daily dose of 50 mg once a day intravenously over 1 hour from day 1 after HSCT. Therapy was continued until 3 days after hematological engraftment (de64257; ned as an absolute neutrophil count of over 500/uL after the nadir). Prophylactic success was de64257; ned as the absence of proven, probable, or suspected systemic fungal infection through the end of prophylaxis therapy and as the absence of a proven or probable systemic fungal infection through the end of the 4-week post treatment period. Results: A total of 35 patients who underwent HSCT were enrolled in the study. Underlying diseases included acute leukemia (n = 18), myelodysplastic syndrome (n = 5), aplastic anemia (n=4), non-Hodgkinâ€™s lymphoma (n = 3), and others (n = 5). HSCT were HLA-matched sibling (n=11), matched unrelated (n=15), mismatched unrelated (n=2) or autologous (n=7). The median durations of administration of micafungin were 14 days (range 12-17 days). Prophylactic success was achieved in 34 (97.1%) of the 35 evaluated patients. No patients showed proven or probable IFI. Micafungin was well tolerated, and none of the patients required dose reduction due to adverse effects. Conclusions: Our results indicate the effectiveness and safety of micafungin a daily dose of 50 mg as an prophylactic antifungal therapy in patients undergoing HSCT.
Full conference title:
Annual Meeting of the EBMT, 38th