Open AccessIsavuconazole in Hematological Patients: Results of a Real‐Life Multicentre Observational Seifem Study
Author(s) -
Cattaneo Chiara,
Busca Alessandro,
Gramegna Doriana,
Farina Francesca,
Candoni Anna,
Piedimonte Monica,
Fracchiolla Nicola,
Pagani Chiara,
Principe Maria Ilaria Del,
Tisi Maria Chiara,
Offidani Massimo,
Fanci Rosa,
Ballanti Stelvio,
Spolzino Angelica,
Criscuolo Marianna,
Marchesi Francesco,
Nadali Gianpaolo,
Delia Mario,
Picardi Marco,
Sciumé Margherita,
Mancini Valentina,
Olivieri Attilio,
Tumbarello Mario,
Rossi Giuseppe,
Pagano Livio
Publication year - 2019
Publication title -
hemasphere
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 11
ISSN - 2572-9241
DOI - 10.1097/hs9.0000000000000320
Subject(s) - discontinuation , tolerability , medicine , adverse effect , observational study , multivariate analysis
Invasive fungal diseases (IFDs) remain a major clinical issue in patients with hematological malignancies (HMs). To confirm the efficacy and safety of the new azole isavuconazole (ISV) in a clinical care setting, we planned a multicenter retrospective study; we collected data on all possible/probable/proven IFDs in patients with HMs treated with ISV in 17 centers. Between July 2016 and November 2018, 128 patients were enrolled, and 122 were fully evaluable. ISV was employed as the 1 st line therapy in 43 (35%) patients and as a subsequent therapy in 79 (65%) patients. The response rate was 82/122 patients (67.2%); it was similar when using ISV as a 1st or 2nd line treatment (60.5% vs 70.9%, respectively; p = 0.24). In multivariate analysis, both female sex (OR: 2.992; CI: 1.22–7.34) and induction phase of treatment (OR: 3.953; CI: 1.085–14.403) were predictive of a favorable response. At a median follow‐up of 5 months, 43 (35.2%) patients were dead; the 1‐year overall survival (OS) was 49.9%. In multivariate analysis, the response to ISV (OR: 0.103; CI: 0.041–0.262) and IFD refractoriness to previous antifungals (OR: 3.413; CI: 1.318–8.838) were statistically significant for OS. Adverse events (AEs) were reported in 15/122 patients (12.3%); grade 3–4 AEs were reported in 5 (4%) and led to ISV discontinuation. Our study confirms the safety and tolerability of ISV, also in diseases other than acute leukemia. Phase of hematological disease, gender and refractoriness to previous antifungals are the main predictive factors for the aforementioned response and outcome.