血液内科領域におけるミカファンギンの使用評価とその課題

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We evaluated the usage, effectiveness, and adverse reactions of micafungin (MCFG) in 17 patients with hematological disorders(6 with acute myelocytic leukemia,2 with chronic myelocytic leukemia,3 with aplastic anemia,4 with myelodysplastic syndrome,1 with multiple myelomas, and 1 with myelofibrosis) being treated in our hospital. Complete remission was achieved in 1 patient, and stabilization in 7,but the condition of 5 became aggravated. Three patients were excluded due to the administration of prophylactics and effectiveness could not be determined in 1 patient. For 9 patients with definite or suspected pulmonary aspergillosis, MCFG was effective in 3 of 4 treated at a dose of 150 mg and in 2 of 5 treated at a dose of 75 mg. The administration of MCFG was discontinued due to adverse reactions and associated symptoms in 7 patients (drug-induced fever in 3,nausea/vomiting in 2,abnormal liver function in 2, drug eruption in 1,and diarrhea in 1 ; including patients with more than 1 symptom). All adverse reactions and associated symptoms were mild in degree, however. From the above observations, we concluded that in the case of administering MCFG for pulmonary aspergillosis, a daily dose of 75 mg is inadequate and a daily dose of 150 mg or more is necessary. Our findings also suggested that for patients who do not respond to conventional antifungal drugs or cannot be treated with an adequate dose of such drugs due to adverse reactions, the high-dose administration of MCFG together with amphotericin B may be effective.
日本医療薬学会の論文
2004-03-10

血液内科領域におけるミカファンギンの使用評価とその課題

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