Efficacy and safety of micafungin as an empirical antifungal therapy for suspected fungal infection in neutropenic patients with hematological disorders

• Published in: Annals of hematology Vol. 91; no. 3; pp. 449 - 457
• Main Authors: Yoshida, Minoru, Tamura, Kazuo, Imamura, Masahiro, Niitsu, Yoshiro, Sasaki, Takeshi, Urabe, Akio, Ohyashiki, Kazuma, Naoe, Tomoki, Kanamaru, Akihisa, Tanimoto, Mitsune, Masaoka, Tohru
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.03.2012; Springer Nature B.V
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Antifungal Agents - therapeutic use; Echinocandins - therapeutic use; Female; Fever; Hematologic Diseases - complications; Hematologic Diseases - physiopathology; Hematology; Humans; imaging; Infection; Japan; Leukocytes (neutrophilic); Lipopeptides - therapeutic use; Male; Medicine; Medicine & Public Health; micafungin; Middle Aged; Mycoses - drug therapy; Mycoses - etiology; Neutropenia; Neutropenia - complications; Neutropenia - physiopathology; Oncology; Original Article; Prospective Studies; Treatment Outcome; Young Adult; Japan; Echinocandin; Micafungin; Hematological disorders; Empirical therapy; Fungal infection; Febrile neutropenia
• ISSN: 0939-5555; 1432-0584
• DOI: 10.1007/s00277-011-1316-y

This prospective multicenter study was performed to clarify the efficacy and safety of micafungin (MCFG) as an empirical antifungal therapy for suspected fungal infection in patients with hematological disorders and neutropenia. Three hundred and eighty-eight patients were enrolled; 151 patients with possible fungal infection diagnosed by radiological imaging or serological testing and 237 patients with refractory fever were included in this study. The mean dose and duration of treatment with MCFG were 154.6 mg/day and 14.0 days, respectively. The clinical response rate for patients with possible fungal infection and refractory fever was 60.1% and 65.3%, respectively. Even in persistent neutropenic patients with a neutrophil count of <500/μL throughout the MCFG treatment, the clinical response rate was 46.9%. Ninety-one drug-related adverse events (DAEs) were observed in 56 patients (14.4%) and 9 serious DAEs were observed in 6 patients (1.5%). Neither daily dose nor duration of MCFG treatment affected the incidence of DAEs. It was confirmed that MCFG has adequate clinical efficacy and is safe for the treatment of suspected fungal infections in patients with hematological disorders and neutropenia.