EJC Supplements
Volume 5, Issue 2 , Pages 43-48 , July 2007

Primary antifungal prophylaxis in leukaemia patients

  • Johan A. Maertens

      Affiliations

    • Department of Haematology, Leukaemia and Stem Cell Transplantation Unit, University Hospital Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium
    • Corresponding Author InformationCorresponding author: Tel.: +32 16 34 68 80; fax: +32 16 34 68 81.
    • ,
  • Pascale Frère

      Affiliations

    • Department of Medicine, Division of Haematology, University of Liege, Liege, Belgium
    • ,
  • Cornelia Lass-Flörl

      Affiliations

    • Department of Hygiene and Medical Microbiology, Medical University of Innsbruck, Austria
    • ,
  • Werner Heinz

      Affiliations

    • Medizinische Klinik und Poliklinik II, Division of Infectious Diseases, University of Würzburg, Würzburg, Germany
    • ,
  • Oliver A. Cornely

      Affiliations

    • Klinik I für Innere Medizin, Klinische Infektiologie, Köln, Germany

Received 14 May 2007 ,Revised 11 June 2007 ,Accepted 12 June 2007.

References 

  1. Viscoli C, Girmenia C, Marinus A, et al. Candidemia in cancer patients: a prospective multicenter surveillance study by the Invasive Fungal Infection Group (IFIG) of the European Organization for Research and Treatment of cancer (EORTC). Clin Infect Dis. 1999;28:1071–1079
  2. Lin SJ, Schranz J, Teutsch SM. Aspergillosis case-fatality rate: systematic review of the literature. Clin Infect Dis. 2001;32:358–366
  3. von Eiff M, Roos N, Schulten R, et al. Pulmonary aspergillosis: early diagnosis improves survival. Respiration. 1995;62:341–347
  4. Hope WW, Walsh TJ, Denning DW. Laboratory diagnosis of invasive aspergillosis. Lancet Infect Dis. 2005;5:609–622
  5. Dykewicz CA. Summary of the guidelines for preventing opportunistic infections among hematopoietic stem cell transplant recipients. Clin Infect Dis. 2001;33:139–144
  6. de Pauw B. Preventative use of antifungal drugs in patients treated for cancer. J Antimicrob Chemother. 2004;53:130–132
  7. Goodman JL, Winston DJ, Greenfield RA, et al. A controlled trial of fluconazole to prevent fungal infections in patients undergoing bone marrow transplantation. New Engl J Med. 1992;326:845–851
  8. Slavin MA, Osborne B, Adams R, et al. Efficacy and safety of fluconazole prophylaxis for fungal infections after marrow transplantation—a prospective, randomized double blind study. J Infect Dis. 1995;171:1545–1552
  9. Rotstein C, Bow EJ, Laverdiere M, et al. Randomized placebo-controlled trial of fluconazole prophylaxis for neutropenic cancer patients: benefit based on purpose and intensity of cytotoxic therapy. Clin Infect Dis. 1999;28:331–340
  10. Schaffner A, Schaffner M. Effect of prophylactic fluconazole on the frequency of fungal infections, amphotericin B use, and health care cost in patients undergoing intensive chemotherapy for hematological neoplasias. J Infect Dis. 1995;172:1035–1041
  11. Winston DJ, Chandrasekar PH, Lazarus HM, et al. Fluconazole prophylaxis of fungal infections in patients with acute leukemia. Results of a randomized, placebo-controlled, double-blind, multicenter trial. Ann Intern Med. 1993;118:495–503
  12. Cornely OA, Ullmann AJ, Karthaus M. Evidence-based assessment of primary antifungal prophylaxis in patients with haematological malignancies. Blood. 2003;101:3365–3372
  13. Bow EJ, Laverdiere M, Lussier N, et al. Antifungal prophylaxis for severely neutropenic chemotherapy patients. A meta-analysis of randomized-controlled clinical trials. Cancer. 2002;94:3230–3246
  14. Marr KA, Seidel K, Slavin MA, et al. Prolonged fluconazole prophylaxis is associated with persistent protection against candidiasis-related death in allogeneic marrow transplant recipients: long-term follow-up of a randomized, placebo-controlled trial. Blood. 2000;96:2055–2061
  15. Huijgens PC, Simoons-Smit AM, Van Loenen AC, et al. Fluconazole versus itraconazole for the prevention of fungal infections in haemato-oncology. J Clin Pathol. 1999;52:376–380
  16. Nucci M, Biasoli I, Akiti T, et al. A double-blind, randomized, placebo-controlled trial of itraconazole capsules as antifungal prophylaxis for neutropenic patients. Clin Infect Dis. 2000;30:300–305
  17. Vreugdenhil G, Van Dijke BJ, Donnelly JP, et al. Efficacy of itraconazole in the prevention of fungal infections among neutropenic patients with hematological malignancies and intensive chemotherapy. A double blind, placebo controlled study. Leuk Lymph. 1993;11:353–358
  18. Menichetti F, Del Favero A, Martino P, et al. Itraconazole oral solution as prophylaxis for fungal infections in neutropenic patients with hematologic malignancies: a randomized, placebo-controlled, double-blind, multicenter trial. Clin Infect Dis. 1999;28:250–255
  19. Morgenstern GR, Prentice AG, Prentice HG, et al. A randomized controlled trial of itraconazole versus fluconazole for the prevention of fungal infections in patients with haematological malignancies. Br J Haematol. 1999;105:901–911
  20. Harousseau J-L, Dekker AW, Stamatoullas-Bastard A, et al. Itraconazole oral solution for primary prophylaxis of fungal infections in patients with haematological malignancy and profound neutropenia: a randomized, double-blind, double-placebo multicenter trial comparing itraconazole and amphotericin B. Antimicrob Agents Chemother. 2000;44:1887–1893
  21. Boogaerts M, Maertens J, Van Hoof A, et al. Itraconazole versus amphotericin B plus nystatin in the prophylaxis of fungal infections in neutropenic cancer patients. J Antimicrob Chemother. 2001;48:97–103
  22. Glasmacher A, Cornely O, Ullmann AJ, et al. An open-label randomized trial comparing itraconazole oral solution with fluconazole oral solution for primary prophylaxis of fungal infections in patients with haematological malignancy and profound neutropenia. J Antimicrob Chemother. 2006;57:317–325
  23. Glasmacher A, Prentice A, Gorschluter M, et al. Itraconazole prevents invasive fungal infections in neutropenic patients treated for hematologic malignancies: evidence from a meta-analysis of 3,597 patients. J Clin Oncol. 2003;21:4615–4626
  24. Winston DJ, Maziarz RT, Chandrasekar PH, et al. Intravenous and oral itraconazole versus intravenous and oral fluconazole for long-term antifungal prophylaxis in allogeneic hematopoietic stem-cell transplant recipients. A multicenter, randomised trial. Ann Intern Med. 2003;138:705–713
  25. Marr KA, Crippa F, Leisenring W, et al. Itraconazole versus fluconazole for prevention of fungal infections in patients receiving allogeneic stem cell transplants. Blood. 2004;103:1527–1533
  26. Vardakas KZ, Michalopoulos A, Falagas ME. Fluconazole versus itraconazole for antifungal prophylaxis in neutropenic patients with haematological malignancies: a meta-analysis of randomised-controlled trials. Br J Haematol. 2005;131:22–28
  27. Marr KA, Crippa F, Leisenring W, et al. Cyclophosphamide metabolism is affected by azole antifungals. Blood. 2004;103:1557–1559
  28. Glasmacher A, Hahn C, Molitor E, et al. Itraconazole trough concentrations in antifungal prophylaxis with six different dosing regimens using hydroxypropyl-β-cyclodextrin oral solution or coated-pellet capsules. Mycoses. 1999;42:591–600
  29. Schwartz S, Behre G, Heinemann V, et al. Aerosolized amphotericin B inhalations as prophylaxis of invasive Aspergillus infections during prolonged neutropenia: results of a prospective, randomized trial. Blood. 1999;93:3654–3661
  30. Rousey SR, Russler S, Gottlieb M, et al. Low-dose amphotericin B prophylaxis against invasive Aspergillus infections in allogeneic marrow transplantation. Am J Med. 1991;91:484–492
  31. Perfect JR, Klotman ME, Gilbert CC, et al. Prophylactic intravenous amphotericin B in neutropenic autologous bone marrow transplant recipients. J Infect Dis. 1992;165:891–897
  32. Tollemar J, Ringdén O, Andersson S, et al. Randomized double-blind study of liposomal amphotericin B (Ambisome) prophylaxis of invasive fungal infections in bone marrow transplant recipients. Bone Marrow Transplant. 1993;12:577–582
  33. Kelsey SM, Goldman JM, McCann S, et al. Liposomal amphotericin B (Ambisome) in the prophylaxis of fungal infections in neutropenic patients: a randomised, double-blind, placebo-controlled study. Bone Marrow Transplant. 1999;23:163–168
  34. Timmers GJ, Zweegman S, Simoons-Smit AM, et al. Amphotericin B colloidal dispersion (Amphocil) vs. fluconazole for the prevention of fungal infections in neutropenic patients: data of a prematurely stopped clinical trial. Bone Marrow Transplant. 2000;25:879–884
  35. van Burik JA, Ratanatharathorn V, Stepan DE, et al. Micafungin versus fluconazole for prophylaxis against invasive fungal infections during neutropenia in patients undergoing hematopoietic stem cell transplantation. Clin Infect Dis. 2004;39:1407–1416
  36. Cornely O, Maertens J, Winston D, et al. Posaconazole versus standard azole therapy for prophylaxis of invasive fungal infections among high-risk neutropenic patients: results of a randomized, multicenter trial. In: Abstracts of the 47th annual meeting of the American society of hematology, Atlanta, Georgia; 2005 [abstract 48-II].
  37. Ullmann AJ, Lipton JH, Vesole DH, et al. Posaconazole versus fluconazole for prophylaxis of invasive fungal infections in allogeneic hematopoietic stem cell transplant recipients with graft-versus-host disease: results of a multicenter trial. In: Abstracts of the 45th Interscience Conference on antimicrobial Agents and Chemotherapy, Washington, DC. American Society for Microbiology, Washington (DC, USA); 2005. p. 418 [abstract M-716].
  38. Marr KA, Seidel K, White TC, et al. Candidemia in allogeneic blood and marrow transplant recipients: evolution of risk factors after the adoption of prophylactic fluconazole. J Infect Dis. 2000;181:309–316
  39. Lionakis MS, Lewis RE, Torres HA, et al. Increased frequency of non-fumigatus Aspergillus species in amphotericin B- or triazole-pre-exposed cancer patients with positive cultures for aspergilli. Diagn Microbiol Infect Dis. 2005;52:15–20
  40. Trifilio S, Verma A, Mehta J. Antimicrobial prophylaxis in hematopoietic stem cell transplant recipients: heterogeneity of current clinical practice. Bone Marrow Transplant. 2004;33:735–739

☆ The ECIL 1 is a common initiative of the following groups or organisations: European Blood and Marrow Transplantation Group, European Organisation for Treatment and Research of Cancer, European Leukemia Net (EU Grant LSHC-CT-2004) and Immunocompromised Host Society.

PII: S1359-6349(07)00008-0

doi: 10.1016/j.ejcsup.2007.06.006

EJC Supplements
Volume 5, Issue 2 , Pages 43-48 , July 2007

Article Tools