Masamoto Y, Nannya Y, Kurokawa M
Department of Hematology & Oncology, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Japan.
J Chemother. 2011 Feb;23(1):17-23. doi: 10.1179/joc.2011.23.1.17.
Although previous invasive fungal diseases (IFD) pose a significant risk of reactivation during successive chemotherapies in patients with acute leukemia, and secondary antifungal prophylaxis is regarded as mandatory, much remains unknown about the optimal strategy including the efficacy of voriconazole. During January 2006 and October 2008, a total of 15 patients with acute leukemia had pulmonary IFD (4 probable and 11 possible cases) before or during chemotherapy. After successful treatment of primary IFD with oral voriconazole, all of them received voriconazole during a total of 35 courses of successive chemotherapy. All but one patient successfully accomplished planned treatment without suspected IFD or significant toxicity despite profound neutropenia. We retrieved the previous reports of myelosuppressive therapies after IFD using various secondary prophylaxes, and showed that voriconazole is the most effective drug to suppress IFD relapses.
尽管既往侵袭性真菌病（IFD）在急性白血病患者后续化疗期间有显著的复发风险，且二级抗真菌预防被视为强制性措施，但关于包括伏立康唑疗效在内的最佳策略仍有很多未知之处。在2006年1月至2008年10月期间，共有15例急性白血病患者在化疗前或化疗期间发生肺部IFD（4例疑似和11例可能病例）。在用口服伏立康唑成功治疗原发性IFD后，所有患者在总共35个疗程的后续化疗期间均接受伏立康唑治疗。除1例患者外，所有患者尽管存在严重中性粒细胞减少症，但均成功完成了计划治疗，未出现疑似IFD或明显毒性。我们检索了既往使用各种二级预防措施进行IFD后骨髓抑制治疗的报告，并表明伏立康唑是抑制IFD复发最有效的药物。
