Micafungin as prophylaxis of invasive fungal infection in patients undergoing haematopoietic stem cell transplantation

Ref ID: 18560

Author:

S. Kim (1), J. Yun (1), H. Kim (2), H. Kim (1), S. Lee (3), S. Bae
(2), N. Lee (3), K. Lee (2), S. Park (1), J. Won (3), D. Hong (1),
H. Park (3)

Author address:

(1)Soonchunhyang University Hospital (Bucheon, KR);
(2)Soonchunhyang University Hospital (Cheonan, KR);
(3)Soonchunhyang University Hospital (Seoul, KR)

Full conference title:

Annual Meeting of the EBMT, 38th

Abstract:

Background: Invasive fungal infection (IFI) such as candidiasis
and mold infections cause signifi cant morbidity and mortality in
hematopoietic stem cell transplantation (HSCT). Although prophylactic antifungal therapy with fl uconazole has become the
standard care for these patients, it has been associated with
the emergence of fl uconazole-resistant Candida infections.
Additionally, fl uconazole is not reliably effective against invasive aspergillosis.
Methods: Between January 2010 and September 2011, We
conducted a prospective study to evaluate the usefulness of
the administration of micafungin (Mycamine® ), a class of echinocandin, as a prophylactic antifungal therapy for patients
undergoing HSCT. Micafungin was started at a daily dose of
50 mg once a day intravenously over 1 hour from day 1 after
HSCT. Therapy was continued until 3 days after hematological
engraftment (defi ned as an absolute neutrophil count of over
500/uL after the nadir).
Prophylactic success was defi ned as the absence of proven,
probable, or suspected systemic fungal infection through the
end of prophylaxis therapy and as the absence of a proven
or probable systemic fungal infection through the end of the
4-week post treatment period.
Results: A total of 35 patients who underwent HSCT were
enrolled in the study. Underlying diseases included acute leukemia (n = 18), myelodysplastic syndrome (n = 5), aplastic anemia (n=4), non-Hodgkin’s lymphoma (n = 3), and others (n = 5).
HSCT were HLA-matched sibling (n=11), matched unrelated
(n=15), mismatched unrelated (n=2) or autologous (n=7).
The median durations of administration of micafungin were 14
days (range 12-17 days). Prophylactic success was achieved
in 34 (97.1%) of the 35 evaluated patients. No patients showed
proven or probable IFI. Micafungin was well tolerated, and none
of the patients required dose reduction due to adverse effects.
Conclusions: Our results indicate the effectiveness and safety
of micafungin a daily dose of 50 mg as an prophylactic antifungal therapy in patients undergoing HSCT.

Abstract Number: P492

Conference Year: 2012

Link to conference website: NULL

New link: NULL

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