Real-world assessment of the effectiveness of posaconazole for the prophylaxis and treatment of invasive fungal infections in hematological patients A retrospective observational study
机构：[a]Department of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China,[b]Leukemia Diagnosis and Treatment Center, Blood Diseases Hospital, Chinese Academy of Medical Sciences, Tianjin, China,[c]Department of Hematology, Kunming General Hospital, Chengdu Military Region, Kunming, Yunnan Province, China,[d]Department of Hematology, The First Affiliated Hospital of Medical School of Zhejiang University, Hangzhou, Zhejiang Province, China,浙江大学医学院附属第一医院[e]Department of Hematology, Ruijin Hospital Affiliated to Medical College of Shanghai Jiaotong University, Shanghai, China,[f]Department of Hematology, The First Bethune Hospital of Jilin University, Changchun, Jilin Province, China,[g]Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China,江苏省人民医院[h]Department of Hematology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province, China,中山大学附属第一医院[i]Department of Hematology, Nanfang Hospital Affiliated to Southern Medical University, Guangzhou, Guangdong Province, China,[j]Department of Hematology, Wuhan Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China,华中科技大学同济医学院附属协和医院[k]Department of Hematology, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province, China,中山大学附属第三医院[l]Department of Hematology, Anhui Provincial Hospital, The First Affiliated Hospital of USTC, Hefei, Anhui Province, China,[m]Department of Hematology, Changhai Hospital, Shanghai, China,[n]Department of Hematology, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China,[o]Department of Hematology, Fourth Medical Center of PLA General Hospital, Beijing, China,[p]Department of Hematology, Peking University People’s Hospital, Beijing, China,[q]Department of Hematology, Tianjin Medical University General Hospital, Tianjin, China,[r]Department of Hematology, Tianjin First Central Hospital, Tianjin, China,[s]Department of Hematology, Shanghai General Hospital, Shanghai, China,[t]Department of Hematology, Tangdu Hospital, Xi’an, Shaanxi Province, China,[u]Department of Hematopoietic Stem Cell Transplantation, 307 Hospital of PLA, Beijing, China,[v]Department of Hematology, Aerospace Central Hospital, Beijing, China,[w]Department of Hematology, Henan Cancer Hospital, Zhengzhou, Henan Province, China,河南省肿瘤医院[x]Department of Hematology, Zhejiang Provincial Hospital of TCM, Hangzhou. Zhejiang Province, China,[y]Department of Hematology, Xinqiao Hospital, Chongqing, China.
The aim of the study was to analyze the efficacy of posaconazole for the prophylaxis and treatment of invasive fungal diseases (IFDs) in patients with hematological malignancies. In this retrospective observational multi-center study, 762 patients from 25 Chinese hematological centers were enrolled. Inclusion criteria were patients with hematological malignancy or they had undergone hematopoietic stem cell transplantation and received at least 1 dose of posaconazole. The primary endpoints were the observation of breakthrough rates and the clinical efficacy of posaconazole prophylaxis. The secondary endpoint was the efficacy of posaconazole for the treatment of IFDs. Of the 762 enrolled patients, 456 (59.8%) were prescribed posaconazole prophylactically while 243 (31.9%) received posaconazole as an IFD treatment (12 proven, 61 probable, 109 possible, and 61 unclassified IFD cases) for >= 7 days. The overall IFD breakthrough rate (probable cases) for the >= 4 days prophylactic treatment (n = 445) group was 1.6% (95% Cl: 0.6%-3.2%), with breakthrough rates of 2.6% for acute myeloid leukemia/myelodysplastic syndrome patients undergoing chemotherapy and 2.2% for hematopoietic stem cell transplantation patients. For primary antifungal prophylaxis, the breakthrough rate was 1.9% and for secondary antifungal prophylaxis 0%. The overall effective IFD remission rate of patients treated for >= 7 days with posaconazole was 56.0% and the effective remission rate of proven/probable/possible IFD cases was 59.3%. The effective remission rate of posaconazole as salvage therapy was 50% (95% CI: 32.4%-67.6%) including 75% (CI: 19.4%-99.4%) for Aspergillus infections. The present retrospective study confirmed posaconazole as IFD prophylaxis and medication for hematological malignancy patients undergoing various treatments in China.
基金：
Merck Sharp & Dohme China, who sponsored the study.
第一作者机构：[a]Department of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China,
通讯作者：
通讯机构：[a]Department of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China,[*1]Department of Hematology, The First Affiliated Hospital of Soochow University, No. 188 Shizi Street, Suzhou 215006, Jiangsu Province, China
推荐引用方式(GB/T 7714)：
Chen Xiaochen,Wang Jianxiang,Wang Sanbin,et al.Real-world assessment of the effectiveness of posaconazole for the prophylaxis and treatment of invasive fungal infections in hematological patients A retrospective observational study[J].MEDICINE.2021,100(30):doi:10.1097/MD.0000000000026772.
APA：
Chen, Xiaochen,Wang, Jianxiang,Wang, Sanbin,Jin, Jie,Li, Junmin...&Wu, Depei.(2021).Real-world assessment of the effectiveness of posaconazole for the prophylaxis and treatment of invasive fungal infections in hematological patients A retrospective observational study.MEDICINE,100,(30)
MLA：
Chen, Xiaochen,et al."Real-world assessment of the effectiveness of posaconazole for the prophylaxis and treatment of invasive fungal infections in hematological patients A retrospective observational study".MEDICINE 100..30(2021)
