Micafungin, a Novel Antifungal Agent, as Empirical Therapy in Acute Leukemia Patients with Febrile Neutropenia
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概要
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Objective: Invasive fungal infection is a major cause of morbidity and mortality in patients with febrile neutropenia unresponsive to antibacterial treatment. Empirical antifungal therapy with amphotericin B has been the standard of care for these patients; however, there remains a need for less toxic alternative drugs. Patients and Methods: We conducted a prospective study to evaluate the efficacy and safety of micafungin (MCFG), a novel antifungal agent of the echinocandin class, in an empirical therapy setting for patients with febrile neutropenia. Results: A total of 31 patients with acute leukemia who developed febrile neutropenia were enrolled in the study. Among them, 18 patients fulfilling the protocoldefined criteria, including 10 with persistent fever and 8 with recurrent fever, received MCFG empirically. Underlying diseases consisted of acute myeloid leukemia (n=15) and acute lymphoblastic leukemia (n=3). The median duration of neutropenia and drug administration was 22 and 9.5 days, respectively. Treatment success, defined as defervescence during the neutropenic period, absence of breakthrough fungal infections, and requiring no replacement of antifungal drugs, was achieved in 14 patients (78%). None of the patients required discontinuation or dose reduction due to adverse events except for one patient with severe hypokalemia. Conclusions: Although the studied patients were limited in number, our results indicate that MCFG is an encouraging agent for empirical antifungal therapy in patients with febrile neutropenia, and deserves further investigation in largescale studies.
著者
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Kiyoi Hitoshi
Department Of Hematology And Oncology Nagoya University Graduate School Of Medicine
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Suzuki Momoko
Department Of Hematology And Oncology Nagoya University Graduate School Of Medicine
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Naoe Tomoki
Department Of Hematologly And Oncology Nagoya University School Of Medicine
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Murata Makoto
Department Of Chemical Science And Engineering Graduate School Of Engineering Science Osaka Universi
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Yokozawa Toshiya
Department Of Hematology Japanese Red Cross Nagoya First Hospital
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Emi Nobuhiko
Department Of Hematology And Clinical Oncology Fujita Health University School Of Medicine
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YANADA Masamitsu
Department of Hematology and Medical Oncology, Fujita Health University School of Medicine
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Iwai Masanori
Department of Infectious Diseases, Nagoya University Graduate School of Medicine
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Yanada Masamitsu
Department of Hematology, Nagoya University Graduate School of Medicine
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Baba Hisashi
Department of Infectious Diseases, Nagoya University Graduate School of Medicine
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Suzuki Momoko
Department of Hematology, Nagoya University Graduate School of Medicine
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