Efficacy and safety of posaconazole in hematopoietic stem cell transplantation patients with invasive fungal disease

Future Microbiol. 2017 Nov:12:1371-1379. doi: 10.2217/fmb-2017-0131. Epub 2017 Sep 7.

Abstract

Aim: Invasive fungal disease (IFD) is a significant cause of morbidity and mortality in hematopoietic stem cell transplantation (HSCT) patients. This study reports real-world efficacy and safety of posaconazole (POS) in HSCT recipients with IFD.

Patients & methods: We performed a retrospective study to investigate the efficacy and safety of POS oral suspension in 45 HSCT patients with IFD from December 2013 to December 2016.

Results: The success rate at 12 weeks after POS treatment was 57.8%. Multivariate logistic regression analysis showed that persistent neutropenia, severe graft-versus-host disease, high-dose steroid and cytomegalovirus infection were independently associated with inferior responses to POS. POS caused some adverse effects of mild or moderate severity that were of short duration.

Conclusion: This study provides encouraging data regarding the efficacy and safety of POS in HSCT recipients. Neutropenia, graft-versus-host disease, steroid use and cytomegalovirus infection are possibly associated with inferior responses to POS therapy.

Keywords: hematopoietic stem cell transplantation; invasive fungal disease; posaconazole.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antifungal Agents / administration & dosage*
  • Antifungal Agents / adverse effects
  • Cytomegalovirus Infections / etiology
  • Female
  • Graft vs Host Disease / etiology
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Humans
  • Invasive Fungal Infections / complications
  • Invasive Fungal Infections / prevention & control*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neutropenia / etiology
  • Primary Prevention*
  • Regression Analysis
  • Retrospective Studies
  • Steroids / therapeutic use
  • Time Factors
  • Transplantation Conditioning
  • Treatment Outcome
  • Triazoles / administration & dosage*
  • Triazoles / adverse effects

Substances

  • Antifungal Agents
  • Steroids
  • Triazoles
  • posaconazole