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Antifungal prophylaxis with micafungin in patients treated for childhood cancer
Author(s) -
Kusuki Shigenori,
Hashii Yoshiko,
Yoshida Hisao,
Takizawa Sachiko,
Sato Emiko,
Tokimasa Sadao,
Ohta Hideaki,
Ozono Keiichi
Publication year - 2009
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.22140
Subject(s) - micafungin , medicine , neutropenia , chemotherapy , hematopoietic stem cell transplantation , adverse effect , pediatric cancer , transplantation , voriconazole , cancer , antifungal , dermatology
Background Invasive fungal infections (IFIs) remain a major cause of infectious morality in neutropenic patients receiving chemotherapy or hematopoietic stem cell transplantation (HSCT). Micafungin exhibits broad antifungal activity against both Aspergillus and Candida species. We performed a retrospective study to determine the efficacy and safety of prophylactic micafungin against IFI in pediatric neutropenic patients during chemotherapy or HSCT. Procedure Forty patients were given micafungin (3 mg/kg/day) intravenously for neutropenia: 131 patient‐cycles (39 patients) after chemotherapy and 15 patient‐cycles (14 patients) after HSCT. Median duration of neutropenia and micafungin prophylaxis was 13 and 23 days after chemotherapy and HSCT, respectively. Results Treatment success rate, defined as absence of proven, probable, possible, or suspected IFIs, was 93.9% (121/131) and 80.0% (12/15) for chemotherapy and HSCT, respectively. Proven or probable IFI was documented in only one patient after HSCT. No adverse events were observed that could be related to micafungin prophylaxis. Conclusions These results suggest that prophylactic micafungin is well tolerated and may prevent IFIs in pediatric patients with neutropenia receiving chemotherapy or HSCT. Pediatr Blood Cancer 2009;53:605–609. © 2009 Wiley‐Liss, Inc.