泊沙康唑作为基础血液系统恶性肿瘤及其他疾病患者侵袭性镰刀菌病的挽救治疗药物。
Posaconazole as salvage treatment for invasive fusariosis in patients with underlying hematologic malignancy and other conditions.
作者信息
Raad Issam I, Hachem Ray Y, Herbrecht Raoul, Graybill John R, Hare Roberta, Corcoran Gavin, Kontoyiannis Dimitrios P
机构信息
The M. D. Anderson Cancer Center, Houston, Texas 77230-1402, USA.
出版信息
Clin Infect Dis. 2006 May 15;42(10):1398-403. doi: 10.1086/503425. Epub 2006 Apr 11.
BACKGROUND
Conventional amphotericin B-based antifungal therapy for invasive fusariosis in patients with a hematologic malignancy results in a > or = 70% failure rate. Posaconazole is a broad-spectrum antifungal agent with in vitro and in vivo activity against Fusarium species.
METHODS
In this retrospective analysis of patients from 3 open-label clinical trials, we evaluated posaconazole for the treatment of invasive fusariosis. Twenty-one patients with proven or probable invasive fusariosis who had disease refractory to or who were intolerant of standard antifungal therapy received oral posaconazole suspension (800 mg per day in divided doses) as salvage therapy.
RESULTS
Successful outcome occurred in 10 (48%) of all 21 patients. Among patients with leukemia who received posaconazole therapy for >3 days, the overall success rate was 50%; for patients who recovered from myelosuppression, the success rate was 67%, compared with 20% for those with persistent neutropenia.
CONCLUSION
These results suggest that posaconazole is useful for the treatment of invasive fusariosis.
背景
对于血液系统恶性肿瘤患者侵袭性镰刀菌病，基于传统两性霉素B的抗真菌治疗失败率≥70%。泊沙康唑是一种广谱抗真菌药，在体外和体内对镰刀菌属均有活性。
方法
在这项对来自3项开放标签临床试验患者的回顾性分析中，我们评估了泊沙康唑治疗侵袭性镰刀菌病的效果。21例确诊或疑似侵袭性镰刀菌病且对标准抗真菌治疗难治或不耐受的患者接受口服泊沙康唑混悬液（每日800mg，分剂量服用）作为挽救治疗。
结果
21例患者中10例（48%）获得成功结局。在接受泊沙康唑治疗超过3天的白血病患者中，总体成功率为50%；从骨髓抑制中恢复的患者成功率为67%，而持续性中性粒细胞减少患者的成功率为20%。
结论
这些结果表明泊沙康唑可用于治疗侵袭性镰刀菌病。
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