Gandolpho Larissa Simão, Ponzio Vinicius, Batista Marjorie Vieira, França E Silva Ivan Leonardo Avelino, Ramos Jessica Fernandes, Nucci Marcio, Colombo Arnaldo Lopes
Division of Infectious Diseases, Escola Paulista de Medicina-Universidade Federal de São Paulo, São Paulo 04023-900, SP, Brazil.
Hospital Nove de Julho, São Paulo 01409-002, SP, Brazil.
J Fungi (Basel). 2025 Jun 16;11(6):456. doi: 10.3390/jof11060456.
(1) Background: Invasive aspergillosis is a life-threatening fungal infection, particularly in patients with hematologic malignancies. Isavuconazole, a broad-spectrum triazole, has emerged as a key treatment option, but real-world data in high-risk populations from middle-income countries remain limited. (2) Methods: We conducted a multicenter, retrospective study to evaluate the clinical response rate and tolerability of isavuconazole in patients with hematologic malignancies and probable or proven invasive aspergillosis across four medical centers in Brazil. (3) Results: We enrolled 50 patients aged 18 to 82 years (64% male) with proven or probable invasive aspergillosis, diagnosed in the context of complex hematologic conditions. Among them, 60% had active or refractory malignancies, and 22% had a prior COVID-19 infection. Isavuconazole was used as a first-line therapy in 64% of cases. No patients discontinued treatment due to toxicity. The 6-week overall survival was 60%. Prior COVID-19 infection was associated with a lower survival rate (44% vs. 69% in patients without COVID-19, = 0.04). (4) Conclusions: This study provides real-world evidence supporting the efficacy and tolerability of isavuconazole in a high-risk population. The findings reinforce its role as a key antifungal therapy, particularly in patients with complex underlying conditions.
(1) 背景：侵袭性曲霉病是一种危及生命的真菌感染，在血液系统恶性肿瘤患者中尤为常见。艾沙康唑是一种广谱三唑类药物，已成为关键的治疗选择，但来自中等收入国家高危人群的真实世界数据仍然有限。(2) 方法：我们进行了一项多中心回顾性研究，以评估艾沙康唑在巴西四个医疗中心患有血液系统恶性肿瘤且可能或确诊为侵袭性曲霉病患者中的临床缓解率和耐受性。(3) 结果：我们纳入了50例年龄在18至82岁之间（64%为男性）、确诊或可能患有侵袭性曲霉病的患者，这些患者是在复杂的血液系统疾病背景下被诊断出来的。其中，60%患有活动性或难治性恶性肿瘤，22%曾感染过新冠病毒。64%的病例将艾沙康唑用作一线治疗。没有患者因毒性而停药。6周总生存率为60%。既往感染新冠病毒与较低的生存率相关（感染新冠病毒的患者为44%，未感染新冠病毒的患者为69%，P = 0.04）。(4) 结论：本研究提供了真实世界证据，支持艾沙康唑在高危人群中的疗效和耐受性。这些发现强化了其作为关键抗真菌治疗药物的作用，特别是在有复杂基础疾病的患者中。
