Gong B F, Liu Y T, Zhang G J, Wei S N, Li Y, Liu K Q, Gong X Y, Zhao X L, Qiu S W, Gu R X, Lin D, Wei H, Zhou C L, Liu B C, Wang Y, Mi Y C, Wang J X
Institute of Hematology & Blood Diseases Hospital, CAMS & PUMC, Tianjin Clinical Research Center for Blood Diseases, Tianjin 300020, China.
Zhonghua Xue Ye Xue Za Zhi. 2017 Jun 14;38(6):528-531. doi: 10.3760/cma.j.issn.0253-2727.2017.06.012.
To evaluate the incidence of invasive fungal infections (IFI) and usage of intravenous antifungal drugs during remission induction chemotherapy in patients with acute myeloid leukemia (AML) under primary antifungal prophylaxis with posaconazole. Clinical records from newly diagnosed AML patients above 15 years old in one single center from February 2014 to January 2016 were retrospectively reviewed and analyzed, excluding acute promyelocytic leukemia. The incidence of IFI and usage of intravenous antifungal drugs were investigated between control group (not receiving any broad spectrum antifungal prophylaxis) and treatment group (receiving posaconazole as primary prophylaxis). A total of 147 newly diagnosed AML patients were enrolled. Of them, 81 received prophylaxis with posaconazole, and 66 did not receive broad-spectrum antifungal treatment. 7 IFI occurred in posaconazole group, and all were possible cases; 19 IFI occurred in control group (3 proven, 4 probable, 12 possible). The incidence of IFI was significantly lower in treatment group than that in control group (8.6% 28.8%, (2)=10.138, =0.001). Usage of intravenous antifungal drugs was significantly decreased in posaconazole group (18.5% 50.0%, (2)=16.390, <0.001). Prophylaxis with posaconazole coulf prevent IFI and reduce usage of intravenous antifungal drugs significantly during remission induction chemotherapy in AML patients.
为评估在接受泊沙康唑一级抗真菌预防的急性髓系白血病（AML）患者缓解诱导化疗期间侵袭性真菌感染（IFI）的发生率及静脉用抗真菌药物的使用情况。回顾性分析了2014年2月至2016年1月在单个中心新诊断的15岁以上AML患者的临床记录，不包括急性早幼粒细胞白血病。在对照组（未接受任何广谱抗真菌预防）和治疗组（接受泊沙康唑作为一级预防）之间调查IFI的发生率和静脉用抗真菌药物的使用情况。共纳入147例新诊断的AML患者。其中，81例接受泊沙康唑预防，66例未接受广谱抗真菌治疗。泊沙康唑组发生7例IFI，均为可能病例；对照组发生19例IFI（确诊3例，很可能4例，可能12例）。治疗组IFI的发生率显著低于对照组（8.6%对28.8%，χ²=10.138，P=0.001）。泊沙康唑组静脉用抗真菌药物的使用显著减少（18.5%对50.0%，χ²=16.390，P<0.001）。在AML患者缓解诱导化疗期间，泊沙康唑预防可显著预防IFI并减少静脉用抗真菌药物的使用。
