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THE USE OF MICAFUNGIN IN PATIENTS WITH HEMATOLOGICAL MALIGNANCIES


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Abstract

Material and Methods. Micafungin was administered in dose of 100 mg intravenously once daily. Results. Primary prophylaxis with micafungin was performed in 16 (46%) of 35 patients, all of them were recipients of allogeneic hematopoietic stem cells (allo-HSC), 81% - had graft-versus-host disease (GVHD) and received prednisolone in dose of ≥ 1 mg/kg daily. Median duration of prophylaxis was of 27 (4-105) days, in 14 (88%)patients - 7 days and more, in 2 (12%) - less than 7 days. Invasive aspergillosis (“probable”) occurred in 1 (7%) of 14 allo-HSCT recipients under micafungin treatment for ≥ 7 days. Micafungin treatment was initiated in 19 (54%) of 35 patients with median duration of 13 (3-32) days. Indications for micafungin treatment were candidemia (n = 7), hepatosplenic candidiasis (n = 4), empirical therapy (n = 6) and preemptive therapy. Fatal outcome was in 2 of 7 patients with candidemia, other patients had favorable outcome. Prior to the beginning of the treatment with micafungin 21 (60%) of 35 patients had elevation in one or more liver function tests. During micafungin treatment liver function parameters decreased in patients with initially elevated levels of these parameters and remained in reference ranges in patients with previously normal values. Conclusion. The study demonstrated the efficacy of micafungin both for prophylaxis of invasive mycoses in allo-HSCT recipients with GVHD and the treatment of proven and suspected invasive candidiasis. We confirmed the safety of the micafungin use in patients with hematological malignancies.


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