Universität zu Köln

Cordonnier, Catherine, Rovira, Montserrat, Maertens, Johan, Olavarria, Eduardo, Faucher, Catherine, Bilger, Karin, Pigneux, Arnaud, Cornely, Oliver A., Ullmann, Andrew J., Bofarull, Rodrigo Martino, de la Camara, Rafael ORCID: 0000-0002-8189-5779, Weisser, Maja ORCID: 0000-0002-0134-1929, Liakopoulou, Effie, Abecasis, Manuel, Heussel, Claus Peter, Pineau, Marc, Ljungman, Per and Einsele, Hermann (2010). Voriconazole for secondary prophylaxis of invasive fungal infections in allogeneic stem cell transplant recipients: results of the VOSIFI study. Haematol-Hematol. J., 95 (10). S. 1762 - 1769. PAVIA: FERRATA STORTI FOUNDATION. ISSN 1592-8721

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Abstract

Background Recurrence of prior invasive fungal infection (relapse rate of 30-50%) limits the success of stem cell transplantation. Secondary prophylaxis could reduce disease burden and improve survival. Design and Methods A prospective, open-label, multicenter trial was conducted evaluating voriconazole (4 mg/kg/12 h intravenously or 200 mg/12 h orally) as secondary antifungal prophylaxis in allogeneic stem cell transplant recipients with previous proven or probable invasive fungal infection. Voriconazole was started 48 h or more after completion of conditioning chemotherapy and was planned to be continued for 100-150 days. Patients were followed for 12 months. The primary end-point of the study was the incidence of proven or probable invasive fungal infection. Results Forty-five patients were enrolled, 41 of whom had acute leukemia. Previous invasive fungal infections were proven or probable aspergillosis (n=31), proven candidiasis (n=5) and other proven or probable infections (n=6); prior infection could not be confirmed in three patients. The median duration of voriconazole prophylaxis was 94 days. Eleven patients (24%) died within 12 months of transplantation, but only one due to systemic fungal disease. Three invasive fungal infections occurred post-transplant: two relapses (one candidemia and one fatal scedosporiosis) and one new zygomycosis in a patient with previous aspergillosis. The 1-year cumulative incidence of invasive fungal disease was 6.7 3.6%. Two patients were withdrawn from the study due to treatment-related adverse events (i.e. liver toxicity). Conclusions Voriconazole appears to be safe and effective for secondary prophylaxis of systemic fungal infection after allogeneic stem cell transplantation. The observed incidence of 6.7% (with one attributable death) is considerably lower than the relapse rate reported in historical controls, thus suggesting that voriconazole is a promising prophylactic agent in this population.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Cordonnier, Catherine UNSPECIFIED UNSPECIFIED UNSPECIFIED Rovira, Montserrat UNSPECIFIED UNSPECIFIED UNSPECIFIED Maertens, Johan UNSPECIFIED UNSPECIFIED UNSPECIFIED Olavarria, Eduardo UNSPECIFIED UNSPECIFIED UNSPECIFIED Faucher, Catherine UNSPECIFIED UNSPECIFIED UNSPECIFIED Bilger, Karin UNSPECIFIED UNSPECIFIED UNSPECIFIED Pigneux, Arnaud UNSPECIFIED UNSPECIFIED UNSPECIFIED Cornely, Oliver A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Ullmann, Andrew J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bofarull, Rodrigo Martino UNSPECIFIED UNSPECIFIED UNSPECIFIED de la Camara, Rafael UNSPECIFIED orcid.org/0000-0002-8189-5779 UNSPECIFIED Weisser, Maja UNSPECIFIED orcid.org/0000-0002-0134-1929 UNSPECIFIED Liakopoulou, Effie UNSPECIFIED UNSPECIFIED UNSPECIFIED Abecasis, Manuel UNSPECIFIED UNSPECIFIED UNSPECIFIED Heussel, Claus Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Pineau, Marc UNSPECIFIED UNSPECIFIED UNSPECIFIED Ljungman, Per UNSPECIFIED UNSPECIFIED UNSPECIFIED Einsele, Hermann UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-495628
DOI:	10.3324/haematol.2009.020073
Journal or Publication Title:	Haematol-Hematol. J.
Volume:	95
Number:	10
Page Range:	S. 1762 - 1769
Date:	2010
Publisher:	FERRATA STORTI FOUNDATION
Place of Publication:	PAVIA
ISSN:	1592-8721
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language B IN-VITRO; AMPHOTERICIN-B; ANTIFUNGAL PROPHYLAXIS; RISK-FACTORS; ASPERGILLOSIS; EXPERIENCE; THERAPY; EPIDEMIOLOGY; ITRACONAZOLE; FLUCONAZOLE Multiple languages Hematology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/49562