摘要
目的:研究伏立康唑初级预防急性髓系白血病(AML)患者化疗期间侵袭性肺曲霉菌感染(IPA)的有效性。方法:回顾性分析2014年2月至2016年1月本中心就诊的102例初治AML(除外急性早幼粒细胞白血病)患者临床资料,根据首次诱导化疗期间接受抗真菌预防治疗药物不同将102例患者分为2组:42例诱导化疗期间接受伏立康唑抗曲霉菌预防治疗,为治疗组; 60例接受泊沙康唑预防治疗,为对照组。观察两组之间诱导化疗期间IPA发生率及预防成功率。结果:伏立康唑组中3例发生IPA,发生率为7. 1%,其中临床诊断1例,拟诊2例;泊沙康唑组中4例发生IPA,发生率为6. 7%,均为拟诊病例。伏立康唑组IPA发生率与对照组无显著差异(P=0. 925)。除发生IPA外,伏立康唑组另有2例进行了抢先静脉抗曲霉菌治疗,预防成功率为88. 1%,而泊沙康唑组另有4例进行了抢先治疗,预防成功率为86. 7%,2组间无显著差异(P=0. 831)。伏立康唑组主要不良事件为视觉异常,其它不良事件发生率与泊沙康唑组无显著差异。结论:伏立康唑预防急性髓系白血病患者诱导化疗期间侵袭性肺曲霉菌病,其疗效与泊沙康唑相当,可以作为初级预防的治疗选择。
Objective:To evaluate the efficacy of primary prophylaxis of voriconazole against invasive infection of pulmonary aspergillosis(II^A)during remission-induction chemotherapy(RIC)of patients with acute myeloid leukemia(AML).Methods:Clinical data of 102 de novo AMLpatients who received primary anti-IPA prophylaxis during the first induction chemotherapy were analyzed retrospectively.All the cases were divided into voriconazole-treated group and posaconazole-treated group according to the prophylactic agent.The incidences of IPA and systemic antifungal treatment during induction chemotherapy were analyzed for both groups.Results:Among 102 enrolled cases,42 cases received voriconazole and other 60 received posaconazole as primary prophylaxis.IPA occurred in 3 cases of voriconazole group(1 probable,2 possible);IPA occurred in 4 cases of posaconazose group,and all were possible cases.The incidence of IPA during remission-induction chemotherapy in vaiconazole group equaled to posaconazose group(7.1%vs.6.7%)(P=0.925).Beside IPA cases,2 cases in voriconazole group and 4 cases in posaconazole group received intravenous anti aspergillosis drugs preemptive treatment,and no significant difference of prophylactic success rate was observed between two groups(88.1%vs.86.7%)(P=0.831).Visual disturbance was the most common adverse event occurred in voriconazole group,but no significant differences of incidences of other adverse effects were observed when compared with posaconazole group.Conclusion:According to similar prophylactic effect with posaconazole,voriconazole appears to be a good alternative for primary prophylaxis of IPA during remission-induction chemotherapy in AML patients.
作者
宫本法
林冬
魏辉
王迎
刘兵城
周春林
刘凯奇
魏述宁
张广吉
刘云涛
弓晓媛
李艳
赵邢力
邱少伟
顾闰夏
秘营昌
王建祥
GONG Ben-Fa;LIN Dong;WEI Hui;WANG Ying;LIU Bing-Cheng;ZHOU Chun-Lin;LIU Kai-Qi;WEI Shu-ling;ZHANG Guang-Ji;LIU Yun-Tao;GONG Xiao-Yuan;LI Yan;ZHAO Xing-Li;QIU Shao-Wei;GU Run-Xia;Ml Ying-Chang;WANG Jianxiang(Institute of Hematology&Blood Disease Hospital,Chinese Academy〇o Medical Sciences&Peking Unioo Medical College,Tianjin Clinical Research Center for Blood Diseases,Tianjin 300020,China)
出处
《中国实验血液学杂志》
CAS
CSCD
北大核心
2018年第5期1269-1274,共6页
Journal of Experimental Hematology
基金
国家重点研发计划项目(2017YFC0909800)
天津市科技计划项目(15ZXLCSY00010)
国家重大科技专项(2017ZX09304024)。
关键词
伏立康唑
侵袭性肺曲霉菌病
急性髓系白血病
voriconazole
invasive pulmonary aspergillosis
acute myeloid leukemia
prophylaxis
