Bridging antifungal prophylaxis with 50 mg or 100 mg micafungin in allogeneic stem cell transplantation: A retrospective analysis

  • Objective: Fluconazle or posaconazole is a standard of care in antifungal prophylaxis for patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT). However, many patients need to interrupt standard prophylaxis due to intolerability, drug‐drug interactions, or toxicity. Micafungin has come to prominence for these patients. However, the optimal biological dose of micafungin stays unclear. Methods: We retrospectively evaluated the efficacy of micafungin as antifungal prophylaxis in HSCT patients. Micafungin was applied as bridging in patients who were not eligible to receive oral posaconazole. Micafungin was either given at a dose of 100 mg or 50 mg SID. Results: A total of 173 patients received micafungin prophylaxis, 62 in the 100 mg and 111 in the 50 mg dose group. The incidence of probable or proven breakthrough IFDs during the observation period was one in the 100 mg and one in the 50 mg group. Fungal‐free survival after 100 days was 98% and 99% (P = .842), and overall survival after 365 days was 60% and 63% (P = .8) respectively. In both groups, micafungin was well tolerated with no grade 3 or 4 toxicities. Conclusion: In this retrospective analysis, which was not powered to detect non‐inferiority, micafungin is effective and complements posaconazole as fungal prophylaxis in HSCT.

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Metadaten
Author:Achim Rothe, Annika Claßen, Jonathan Carney, Michael Hallek, Sibylle Christiane Mellinghoff, Christoph Scheid, Udo Holtick, Michael von Bergwelt‐Baildon
URN:urn:nbn:de:hebis:30:3-563044
DOI:https://doi.org/10.1111/ejh.13372
ISSN:1600-0609
Parent Title (English):European journal of haematology
Publisher:Wiley-Blackwell
Place of publication:Oxford
Document Type:Article
Language:English
Date of Publication (online):2019/12/16
Date of first Publication:2019/12/16
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2020/10/22
Tag:immunology and infectious diseases; transplantation
Volume:104.2020
Issue:4
Page Number:8
First Page:291
Last Page:298
HeBIS-PPN:47252710X
Institutes:Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Sammlungen:Universitätspublikationen
Licence (English):License LogoCreative Commons - Namensnennung-Nicht kommerziell 4.0