Micafungin, a novel antifungal agent, as empirical therapy in acute leukemia patients with febrile neutropenia

Yanada, Masamitsu, Kiyoi, Hitoshi, Murata, Makoto, Suzuki, Momoko, Iwai, Masanori, Yokozawa, Toshiya, Baba, Hisashi, Emi, Nobuhiko and Naoe, Tomoki (2006) Micafungin, a novel antifungal agent, as empirical therapy in acute leukemia patients with febrile neutropenia. Internal Medicine, 45 5: 259-264. doi:10.2169/internalmedicine.45.1498

Author Yanada, Masamitsu
Kiyoi, Hitoshi
Murata, Makoto
Suzuki, Momoko
Iwai, Masanori
Yokozawa, Toshiya
Baba, Hisashi
Emi, Nobuhiko
Naoe, Tomoki
Title Micafungin, a novel antifungal agent, as empirical therapy in acute leukemia patients with febrile neutropenia
Journal name Internal Medicine   Check publisher's open access policy
ISSN 0918-2918
Publication date 2006
Sub-type Article (original research)
DOI 10.2169/internalmedicine.45.1498
Open Access Status DOI
Volume 45
Issue 5
Start page 259
End page 264
Total pages 6
Place of publication Tokyo, Japan
Publisher Japanese Society of Internal Medicine
Language eng
Formatted abstract
Objective: Invasive fungal infection is a major cause of morbidity and mortality in patients with febrile neutropenia unresponsive to antibacterial treatment. Empirical antifungal therapy with amphotericin B has been the standard of care for these patients; however, there remains a need for less toxic alternative drugs.
Patients and Methods: We conducted a prospective study to evaluate the efficacy and safety of micafungin (MCFG), a novel antifungal agent of the echinocandin class, in an empirical therapy setting for patients with febrile neutropenia.
Results: A total of 31 patients with acute leukemia who developed febrile neutropenia were enrolled in the study. Among them, 18 patients fulfilling the protocoldefined criteria, including 10 with persistent fever and 8 with recurrent fever, received MCFG empirically. Underlying diseases consisted of acute myeloid leukemia (n=15) and acute lymphoblastic leukemia (n=3). The median duration of neutropenia and drug administration was 22 and 9.5 days, respectively. Treatment success, defined as defervescence during the neutropenic period, absence of breakthrough fungal infections, and requiring no replacement of antifungal drugs, was achieved in 14 patients (78%). None of the patients required discontinuation or dose reduction due to adverse events except for one patient with severe hypokalemia.
Conclusions: Although the studied patients were limited in number, our results indicate that MCFG is an encouraging agent for empirical antifungal therapy in patients with febrile neutropenia, and deserves further investigation in largescale studies.
Keyword Fungal infection
Empirical therapy
Febrile neutropenia
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
ERA 2012 Admin Only
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Created: Fri, 17 Apr 2009, 14:04:32 EST by Ms Karen Naughton on behalf of Anaesthesiology and Critical Care - RBWH