EFFICACY OF ITRACONAZOLE IN THE PREVENTION OF FUNGAL-INFECTIONS AMONG NEUTROPENIC PATIENTS WITH HEMATOLOGIC MALIGNANCIES AND INTENSIVE CHEMOTHERAPY - A DOUBLE-BLIND, PLACEBO-CONTROLLED STUDY

被引：85

作者：

VREUGDENHIL, G ^{[1
]}

VANDIJKE, BJ ^{[1
]}

DONNELLY, JP ^{[1
]}

NOVAKOVA, IRO ^{[1
]}

RAEMAEKERS, JMM ^{[1
]}

HOOGKAMPKORSTANJE, MAA ^{[1
]}

KOSTER, M ^{[1
]}

DEPAUW, BE ^{[1
]}

机构：

[1] UNIV HOSP NIJMEGEN,DEPT INTERNAL MED,DIV HEMATOL,6500 HB NIJMEGEN,NETHERLANDS

来源：

LEUKEMIA & LYMPHOMA | 1993年 / 11卷 / 5-6期

关键词：

ITRACONAZOLE; NEUTROPENIA; LEUKEMIA; FUNGAL INFECTION; PROPHYLAXIS;

D O I：

10.3109/10428199309067926

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

We studied the efficacy and safety of itraconazole for the prevention of fungal infection in neutropenic patients given cytotoxic chemotherapy for hematologic malignancies. Patients were randomly allocated to receive either itraconazole (200 mg bd) or placebo in addition to oral amphotericin B until the patient either developed fungal infection or had completed antileukemic treatment. Forty six patients (83 neutropenic episodes) treated with itraconazole and 46 placebo treated patients (84 neutropenic episodes) were evaluable. No specific toxicity was noted. Nine fungal infections developed in the itraconazole group, of which four were histologically or microbiologically proven and 15 in the patients given placebo (eight proven) (p < 0. 12). All these patients received IV amphotericin B. The incidence of Candida albicans infections tended to be lower in the itraconazole group, but overall, there was no measurable improvement in the prevention of fungal infections and mortality by itraconazole.

引用

页码：353 / 358

页数：6

共 32 条

[1] De Gregorio M.W., Lee W.M.F., Linker C.A., Jacobs R.A., Ries C.A., Fungal infections in patients with acute leukemia, Am. J. Med., 73, pp. 543-548, (1982)
[2] Martino P., Girmenia C., Venditti M., Et al., Candida colonization and systemic infection in neutropenic patients. A retrospective study, Cancer, 64, pp. 2030-2034, (1989)
[3] Verfaillie C., Weisdorf R., Haake R., Hostetter M., Ramsay N.K.C., McGlave P., Candida infections in bone marrow transplant recipients, Bone Marrow Transplant., 8, pp. 177-184, (1991)
[4] Medoff G., Kobayashi G.S., Strategies in the treatment of systemic fungal infections, N. Eng. J. Med., 302, pp. 145-155, (1980)
[5] Gallis H.A., Drew R.H., Pickard W.W., Am-photericin-B: 30 years of clinical experience, Rev. Infectious Diseases, 12, pp. 308-329, (1990)
[6] Meunier F., Fungal infections in the immunocompro-mised host, Clinical Approach to Infection in the Immu-nocompromised Host, pp. 193-220, (1988)
[7] Wingard J.R., Merz W.G., Rinaldi M.G., Johnson T.R., Karp J.E., Saral R., Increase in Candida Kru-sei infection among patients with bone marrow transplantation and neutropenia treated prophytactically with fluconazole, N. Eng. J. Med., 325, pp. 1274-1277, (1991)
[8] DeGregorio M.W., Lee W.M.F., Ries C.A., Candida infections in patients with acute leukemia: Ineffectiveness of nystatin prophylaxis and relationship between or-opharyngeal and systemic candidiasis, Cancer, 50, pp. 2780-2784, (1982)
[9] Gunther I., Kaben U., Dunker H., Brijmohan-Gunther R., Konrad H., Selective decontamination of the digestive tract and fungal infection in acute leukemia patients, Recent Results Cancer Res., 108, pp. 83-88, (1988)
[10] Rousey S.R., Russler S., Gottlieb M., Ash R.C., Low-dose amphotericin B prophylaxis against invasive aspergillus infections in allogeneic marrow transplantation, Am. J. Med., 91, pp. 484-492, (1991)

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