TY - JOUR
T1 - Micafungin as empirical antifungal therapy in hematological patients
T2 - A retrospective, multicenter study in the Czech and Slovak Republics
AU - Racil, Zdenek
AU - Toskova, Martina
AU - Kocmanova, Iva
AU - Buresova, Lucie
AU - Kouba, Michal
AU - Drgona, Lubos
AU - Masarova, Lucia
AU - Guman, Tomas
AU - Tothova, Elena
AU - Gabzdilova, Julia
AU - Forsterova, Kristina
AU - Haber, Jan
AU - Ziakova, Barbora
AU - Bojtarova, Eva
AU - Rolencova, Monika
AU - Timilsina, Shira
AU - Cetkovsky, Petr
AU - Mayer, Jiri
N1 - Funding Information:
This work was supported by CELL – the CzEch Leukemia Study Group for Life, by the CEITEC – CZ.1.05/1.1.00/02.0068, and by grant no. MSM0021622430 from the Ministry of Education, Youth, and Sports of the Czech Republic.
PY - 2013/5
Y1 - 2013/5
N2 - The objective of this retrospective, multicenter study was to evaluate the efficacy and safety of micafungin as empirical antifungal therapy during febrile neutropenia (FN) in 73 hematological patients from six centers in two countries. All patients received 100 mg of micafungin/day. The overall favorable response rate (RR) was 64.8% when the resolution of fever during neutropenia was included in the response criteria and 84.5% when excluded. A significantly lower favorable RR in patients with persistent fever and non-specific pulmonary infiltrates compared to patients with persistent fever only (82.8 vs. 52.4%, respectively; p = 0.011) was not found when resolution of fever was not included in the composite endpoint criteria (93.1 vs. 78.6%, respectively; p = 0.180). Breakthrough fungal disease developed in 2.7% of patients. Treatment was discontinued in 16.4% of cases. Only one patient (1.4%) discontinued therapy due to an adverse event. Posaconazole prophylaxis improved favorable RR when defervescence was included as composite endpoint criterion (p = 0.047), but not when it was excluded (p = 0.485). However, neutrophil recovery did not influence favorable RR (p = 0.803 and p = 0.112, respectively). These data suggest that micafungin is safe and effective as an empirical therapy in patients with FN.
AB - The objective of this retrospective, multicenter study was to evaluate the efficacy and safety of micafungin as empirical antifungal therapy during febrile neutropenia (FN) in 73 hematological patients from six centers in two countries. All patients received 100 mg of micafungin/day. The overall favorable response rate (RR) was 64.8% when the resolution of fever during neutropenia was included in the response criteria and 84.5% when excluded. A significantly lower favorable RR in patients with persistent fever and non-specific pulmonary infiltrates compared to patients with persistent fever only (82.8 vs. 52.4%, respectively; p = 0.011) was not found when resolution of fever was not included in the composite endpoint criteria (93.1 vs. 78.6%, respectively; p = 0.180). Breakthrough fungal disease developed in 2.7% of patients. Treatment was discontinued in 16.4% of cases. Only one patient (1.4%) discontinued therapy due to an adverse event. Posaconazole prophylaxis improved favorable RR when defervescence was included as composite endpoint criterion (p = 0.047), but not when it was excluded (p = 0.485). However, neutrophil recovery did not influence favorable RR (p = 0.803 and p = 0.112, respectively). These data suggest that micafungin is safe and effective as an empirical therapy in patients with FN.
KW - Empirical therapy
KW - Febrile neutropenia
KW - Hematological malignancy
KW - Micafungin
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U2 - 10.3109/10428194.2012.729057
DO - 10.3109/10428194.2012.729057
M3 - Article
C2 - 23088794
AN - SCOPUS:84876257583
SN - 1042-8194
VL - 54
SP - 1042
EP - 1047
JO - Leukemia and Lymphoma
JF - Leukemia and Lymphoma
IS - 5
ER -