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Efficacy and safety of micafungin as an empirical antifungal agent for febrile neutropenic patients with hematological diseases.

Authors
Park, JS; Kim, DH; Choi, CW; Jeong, SH; Choi, JH; Kim, K; Kim, SJ; Jung, CW; Yang, DH; Jang, JH
Citation
Acta haematologica, 124(2):92-97, 2010
Journal Title
Acta haematologica
ISSN
0001-57921421-9662
Abstract
BACKGROUND: This observational study was conducted to document the efficacy and safety of the use of micafungin (Mycamine) as an empirical antifungal agent in febrile neutropenic patients.

METHODS: Micafungin was administered for sustained fever (>38.4°C) on days 3-5 following the initiation of empirical antibiotic therapy. The overall success rate and side effects were evaluated.

RESULTS: A total of 47 patients with acute myeloid leukemia, acute lymphoblastic leukemia, myelodysplastic syndrome and lymphoma were enrolled in the study. The overall success rate of micafungin was 61.7% (29/47). A total of 3 patients (6.4%) experienced grade 3/4 elevations in their aspartate aminotransferase levels, and 10 patients (21%) experienced grade 3/4 hyperbilirubinemia, 9 of which resolved. Four patients died of septic shock. Younger patients (<50 years) and patients with acute lymphoblastic leukemia exhibited a better response to micafungin than other patients. Patients that were less profoundly neutropenic (≥0.05 × 10(9)/l) also had a better response to micafungin, as did the patients who recovered from their fever or neutropenia.

CONCLUSION: Micafungin has an excellent efficacy (61.7%) and safety profile when used as an empirical antifungal agent in febrile neutropenic patients with hematological disorders.
MeSH terms
AdolescentAdultAgedAged, 80 and overAnti-Bacterial Agents/therapeutic useAntifungal Agents/*administration & dosage/adverse effectsEchinocandins/*administration & dosage/adverse effectsFemaleFever/*drug therapy/immunologyHumansImmunocompromised HostLeukemia, Myeloid, Acute/*complications/immunologyLipopeptides/*administration & dosage/adverse effectsLymphoma/complications/immunologyMaleMiddle AgedMycoses/*drug therapy/immunologyMyelodysplastic Syndromes/complications/immunologyNeutropenia/*complications/immunologyPrecursor Cell Lymphoblastic Leukemia-Lymphoma/complications/immunologyProspective StudiesYoung Adult
DOI
10.1159/000315558
PMID
20664196
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Hematology-Oncology
AJOU Authors
박, 준성정, 성현최, 진혁
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