Abstract
To investigate the efficacy and safety of voriconazole in treating Chinese patients with hematological malignancies and invasive aspergillosis. From March 2007 to April 2012, patients with diagnoses confirmed by CT, GM test and/or PCR assays, were recruited into this study. Aspergillosis of all patients were treated with voriconazole 6 mg/kg intravenous infusion (iv) every 12 h for 1 day, followed by 4 mg/kg IV every 12 h for 10-15 days; Then, switch to oral administration that was 200 mg every 12 h for 4-12 weeks. Efficacy and safety were evaluated according to Practice Guideline of Infectious Diseases Society of America. The overall response rate of 38 patients after voriconazole treatment was 81.6%. The median time to pyretolysis was 4.5 days. Treatment related side effects were mild and found in only 15.8% of cases. No treatment related deaths occurred. Voriconazole can considered to be a safe and effective front-line therapy to treat patients with hematological malignancies and invasive aspergillosis. Alternatively it could be used as a remedial treatment when other antifungal therapies are ineffective.
Highlights
The incidence of invasive fungal disease is significantly increased in patients with malignant hematological disorders, with main risk factors including long-term or repeated cycles of chemotherapy, administration of broad-spectrum antibiotics and stem cell transplantation (Hoenigl et al, 2012)
It is urgent to develop a medication to cope with invasive aspergillosis in patients with malignant hematological disorders
Clinical diagnostic criteria: Definition of invasive fungal infection is in line with previous report (Nicolle et al, 2011)
Summary
The incidence of invasive fungal disease is significantly increased in patients with malignant hematological disorders, with main risk factors including long-term or repeated cycles of chemotherapy, administration of broad-spectrum antibiotics and stem cell transplantation (Hoenigl et al, 2012). Conventional treatment in this setting is unsatisfactory, eg., itraconazole is low in its bioavailability and further could induce drug resistance, amphotericin B is associated with severe adverse reactions (Miller et al, 2011). On this background, it is urgent to develop a medication to cope with invasive aspergillosis in patients with malignant hematological disorders. To observe efficacy and safety of voriconazole in treating invasive aspergillosis for patients with malignant hematological disorders, we conducted current study
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