Gangneux Jean-Pierre, El Cheikh Jean, Herbrecht Raoul, Yakoub-Agha Ibrahim, Quiniou Jean-Baptiste, Caillot Denis, Michallet Mauricette
Department of Parasitology and Myology, Hospital Pontchaillou, Rennes, France.
Department of Transplantation and Cellular Therapy, Paoli Calmettes Institute, Marseille, France.
Infect Dis Ther. 2018 Sep;7(3):309-325. doi: 10.1007/s40121-018-0203-4. Epub 2018 Jun 9.
The frequency of invasive fungal diseases (IFDs) has increased in recent years. Within a context where both treatments and guidelines are fast evolving, we aim to shed new light on IFD management in hematologic departments in France.
A multicenter cross-sectional observational study was prospectively conducted in 24 French centers in September and October 2013.
Four hundred ninety-four hospitalized children and adult patients suffering from hematologic malignancy were enrolled: 147 (30%) were allogeneic hematopoietic stem cell transplant (HSCT) recipients, 131 (27%) were patients with acute myeloblastic leukemia or myelodysplastic syndrome (MDS), 71 (14%) were patients with acute lymphoblastic leukemia who did not undergo allogeneic HSCT, and the 145 (29%) remaining patients did not belong to the three above groups. Two hundred forty-six patients (50%) received antifungal treatment, which was prophylactic in 187 (76%) treated patients. These rates were similar across all groups (63-80%). Patients received prophylaxis with an azole (79%), intravenous amphotericin B formulation (10%), echinocandin (9%), or two combination drugs (2%).
Results indicate that prophylaxis is the leading antifungal strategy in French hematology units, regardless of the disease condition, representing 76% of prescriptions for antifungal therapy.
Astellas Pharma France.
近年来，侵袭性真菌病（IFD）的发病率有所上升。在治疗方法和指南都快速发展的背景下，我们旨在为法国血液科IFD的管理提供新的见解。
2013年9月和10月，在法国24个中心前瞻性地开展了一项多中心横断面观察性研究。
共纳入494例患有血液系统恶性肿瘤的住院儿童和成人患者：147例（30%）为异基因造血干细胞移植（HSCT）受者，131例（27%）为急性髓系白血病或骨髓增生异常综合征（MDS）患者，71例（14%）为未接受异基因HSCT的急性淋巴细胞白血病患者，其余145例（29%）患者不属于上述三组。246例患者（50%）接受了抗真菌治疗，其中187例（76%）接受治疗的患者为预防性用药。所有组的这些比例相似（63%-80%）。患者接受的预防性用药包括唑类（79%）、静脉用两性霉素B制剂（10%）、棘白菌素（9%）或两种联合药物（2%）。
结果表明，无论疾病状况如何，预防性用药是法国血液科主要的抗真菌策略，占抗真菌治疗处方的76%。
法国安斯泰来制药公司。
