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Infections Post Transplant

Secondary antifungal prophylaxis with voriconazole to adhere to scheduled treatment in leukemic patients and stem cell transplant recipients

Bone Marrow Transplantation volume 33, pages 943–948 (2004)Cite this article

Summary:

Although the efficacy and safety of voriconazole to treat invasive fungal infections have been demonstrated in prospective trials, its use for secondary prophylaxis to prevent reactivation of these infections remains unknown. Delaying the scheduled treatment of leukemia until complete resolution of fungal infection may have major implications for prognosis. We report 11 leukemic patients with previous aspergillus (n=10) and candida (n=1) infection who received voriconazole 400 mg/day intravenously or orally for between 44 and 245 days. Nine patients were scheduled for allogeneic stem cell transplant, and two for consolidation therapy for acute leukemia. None of the patients had a relapse of fungal infection, and scheduled treatment was delayed only once. Voriconazole was well tolerated, except in one patient who had abnormal liver tests secondary to hepatic graft-versus-host disease, and one who had visual disturbances. This small but homogeneous series indicates that voriconazole may be useful to prevent fungal relapse during at-risk periods in leukemic patients. Prospective trials are warranted to confirm these encouraging results.

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Acknowledgements

This study has been partially presented as a poster at the 42nd Interscience Conference on Antimicrobial Agents and Chemotherapy, San Diego, CA, 27–30 September 2002 (Abstract M 894). We thank the mycology departments of each center for providing the mycology data, and Pamela Johnson for her help in the finalization of the manuscript.

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Authors and Affiliations

  1. Hematology Department, Henri Mondor Hospital, Créteil, France

    C Cordonnier, S Maury, C Pautas, S Chehata & M Kuentz

  2. Hematology Department, Hôpital du Chesnay, Versailles, France

    J N Bastié & S Castaigne

  3. Parasitology-Mycology Department, Henri Mondor Hospital, Créteil, France

    S Bretagne

  4. Bone Marrow Transplant Unit, Saint-Louis Hospital, Paris, 75475, France

    P Ribaud

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  1. C Cordonnier
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  2. S Maury
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  3. C Pautas
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  4. J N Bastié
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  5. S Chehata
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  6. S Castaigne
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  8. S Bretagne
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  9. P Ribaud
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Correspondence to C Cordonnier.

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Cordonnier, C., Maury, S., Pautas, C. et al. Secondary antifungal prophylaxis with voriconazole to adhere to scheduled treatment in leukemic patients and stem cell transplant recipients. Bone Marrow Transplant 33, 943–948 (2004). https://doi.org/10.1038/sj.bmt.1704469

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  • DOI: https://doi.org/10.1038/sj.bmt.1704469

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