Universität zu Köln

Rothe, Achim, Classen, Annika, Carney, Jonathan, Hallek, Michael, Mellinghoff, Sibylle C., Scheid, Christoph, Holtick, Udo and von Bergwelt-Baildon, Michael (2020). Bridging antifungal prophylaxis with 50 mg or 100 mg micafungin in allogeneic stem cell transplantation: A retrospective analysis. Eur. J. Haematol., 104 (4). S. 291 - 299. HOBOKEN: WILEY. ISSN 1600-0609

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Abstract

Objective Fluconazole 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.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Rothe, Achim UNSPECIFIED UNSPECIFIED UNSPECIFIED Classen, Annika UNSPECIFIED UNSPECIFIED UNSPECIFIED Carney, Jonathan UNSPECIFIED UNSPECIFIED UNSPECIFIED Hallek, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Mellinghoff, Sibylle C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Scheid, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Holtick, Udo UNSPECIFIED UNSPECIFIED UNSPECIFIED von Bergwelt-Baildon, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-348569
DOI:	10.1111/ejh.13372
Journal or Publication Title:	Eur. J. Haematol.
Volume:	104
Number:	4
Page Range:	S. 291 - 299
Date:	2020
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1600-0609
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language INVASIVE FUNGAL-INFECTIONS; HIGH-RISK PATIENTS; NEUTROPENIC PATIENTS; BONE-MARROW; FLUCONAZOLE; PREVENTION; DISEASES; VORICONAZOLE; RECIPIENTS; AGENTS Multiple languages Hematology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/34856