Zhang Ya-Ting, Wang Jian, Zhou Dun-Hua, Fang Jian-Pei
Department of Pediatrics, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, Guangdong Province, China.
Department of Pediatrics, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, Guangdong Province, China,E-mail:
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2021 Dec;29(6):1710-1713. doi: 10.19746/j.cnki.issn.1009-2137.2021.06.003.
To explore the effect of posaconazole in the primary prevention of invasive fungal disease (IFD) in the induction therapy of childhood acute lymphoblastic leukemia (ALL).
From August 2018 to November 2020, 144 pediatric patients with ALL treated in Department of Pediatrics, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University were selected, 88 cases received fluconazole as IFD prophylaxis (fluconazole prophylaxis group), 56 cases received posaconazole as IFD prophylaxis (posaconazole prophylaxis group). The incidence of IFD and treatment-related adverse reactions between the two groups were compared, and the safety of posaconazole was evaluated.
The incidence of IFD in the fluconazole prophylaxis group was 20.4% (18/88), and in the posaconazole prophylaxis group was 7.1% (4/56). The incidence of IFD between the two groups was statistically significant different(P=0.030). There was no serious adverse reactions in the two groups. The incidence of mild adverse reactions in the posaconazole prophylaxis group (23.2%) was lower than that in the fluconazole prophylaxis group(39.8%), and the difference was statistically significant (P=0.039). There were 12 cases died in the fluconazole prophylaxis group and 4 in the posaconazole prophylaxis group, while no significant difference in the overall survival rate between the two groups (P=0.281).
The effect of posaconazole in the primary prophylaxis of IFD is better and incidence of adverse reactions is lower than fluconazole. Posaconazole can be tolerated, and expected to become the first-line primary prophylaxis drug for IFD during the induction remission therapy of childhood ALL.
探讨泊沙康唑在儿童急性淋巴细胞白血病（ALL）诱导治疗中对侵袭性真菌病（IFD）的一级预防作用。
选取2018年8月至2020年11月在中山大学孙逸仙纪念医院儿科治疗的144例ALL患儿，88例接受氟康唑作为IFD预防用药（氟康唑预防组），56例接受泊沙康唑作为IFD预防用药（泊沙康唑预防组）。比较两组IFD的发生率及治疗相关不良反应，并评估泊沙康唑的安全性。
氟康唑预防组IFD发生率为20.4%（18/88），泊沙康唑预防组为7.1%（4/56）。两组IFD发生率差异有统计学意义（P=0.030）。两组均未出现严重不良反应。泊沙康唑预防组轻度不良反应发生率（23.2%）低于氟康唑预防组（39.8%），差异有统计学意义（P=0.039）。氟康唑预防组死亡12例，泊沙康唑预防组死亡4例，两组总生存率差异无统计学意义（P=0.281）。
泊沙康唑对IFD的一级预防效果优于氟康唑，不良反应发生率更低。泊沙康唑耐受性良好，有望成为儿童ALL诱导缓解治疗期间IFD的一线一级预防用药。
