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dc.contributor.authorCordonnier, C
dc.contributor.authorRovira, M
dc.contributor.authorMaertens, J
dc.contributor.authorOlavarria, E
dc.contributor.authorFaucher, C
dc.contributor.authorBilger, K
dc.contributor.authorPigneux, A
dc.contributor.authorCornely, O
dc.contributor.authorUllmann, A
dc.contributor.authorBofarull, R
dc.contributor.authorDe la Cámara, R
dc.contributor.authorWeisser, M
dc.contributor.authorLiakopoulou, Effie F
dc.contributor.authorAbecasis, M
dc.contributor.authorHeussel, C
dc.contributor.authorPineau, M
dc.contributor.authorLjungman, P
dc.contributor.authorEinsele, H
dc.date.accessioned2010-11-18T16:53:24Z
dc.date.available2010-11-18T16:53:24Z
dc.date.issued2010-10
dc.identifier.citationVoriconazole for secondary prophylaxis of invasive fungal infections in allogeneic stem cell transplant recipients: results of the VOSIFI study. 2010, 95 (10):1762-8 Haematologicaen
dc.identifier.issn1592-8721
dc.identifier.pmid20634495
dc.identifier.doi10.3324/haematol.2009.020073
dc.identifier.urihttp://hdl.handle.net/10541/115837
dc.description.abstractBACKGROUND: Recurrence of prior invasive fungal infection (relapse rate of 30-50%) limits the success of stem cell transplantation. Secondary prophylaxis could reduce disease burden and improve survival. DESIGN AND METHODS: A prospective, open-label, multicenter trial was conducted evaluating voriconazole (4 mg/kg/12 h intravenously or 200 mg/12 h orally) as secondary antifungal prophylaxis in allogeneic stem cell transplant recipients with previous proven or probable invasive fungal infection. Voriconazole was started 48 h or more after completion of conditioning chemotherapy and was planned to be continued for 100-150 days. Patients were followed for 12 months. The primary end-point of the study was the incidence of proven or probable invasive fungal infection. RESULTS: Forty-five patients were enrolled, 41 of whom had acute leukemia. Previous invasive fungal infections were proven or probable aspergillosis (n=31), proven candidiasis (n=5) and other proven or probable infections (n=6); prior infection could not be confirmed in three patients. The median duration of voriconazole prophylaxis was 94 days. Eleven patients (24%) died within 12 months of transplantation, but only one due to systemic fungal disease. Three invasive fungal infections occurred post-transplant: two relapses (one candidemia and one fatal scedosporiosis) and one new zygomycosis in a patient with previous aspergillosis. The 1-year cumulative incidence of invasive fungal disease was 6.7±3.6%. Two patients were withdrawn from the study due to treatment-related adverse events (i.e. liver toxicity). CONCLUSIONS: Voriconazole appears to be safe and effective for secondary prophylaxis of systemic fungal infection after allogeneic stem cell transplantation. The observed incidence of 6.7% (with one attributable death) is considerably lower than the relapse rate reported in historical controls, thus suggesting that voriconazole is a promising prophylactic agent in this population.
dc.language.isoenen
dc.subjectVoriconazoleen
dc.subjectProphylaxisen
dc.subjectFungal Infectionen
dc.subjectAllogeneic Stem Cell Transplantationen
dc.titleVoriconazole for secondary prophylaxis of invasive fungal infections in allogeneic stem cell transplant recipients: results of the VOSIFI study.en
dc.typeArticleen
dc.contributor.departmentService d'Hématologie Clinique, Hôpital Henri Mondor, 51 Av. Maréchal de Lattre de Tassigny, Créteil, France. carlcord@club-internet.fren
dc.identifier.journalHaematologicaen
html.description.abstractBACKGROUND: Recurrence of prior invasive fungal infection (relapse rate of 30-50%) limits the success of stem cell transplantation. Secondary prophylaxis could reduce disease burden and improve survival. DESIGN AND METHODS: A prospective, open-label, multicenter trial was conducted evaluating voriconazole (4 mg/kg/12 h intravenously or 200 mg/12 h orally) as secondary antifungal prophylaxis in allogeneic stem cell transplant recipients with previous proven or probable invasive fungal infection. Voriconazole was started 48 h or more after completion of conditioning chemotherapy and was planned to be continued for 100-150 days. Patients were followed for 12 months. The primary end-point of the study was the incidence of proven or probable invasive fungal infection. RESULTS: Forty-five patients were enrolled, 41 of whom had acute leukemia. Previous invasive fungal infections were proven or probable aspergillosis (n=31), proven candidiasis (n=5) and other proven or probable infections (n=6); prior infection could not be confirmed in three patients. The median duration of voriconazole prophylaxis was 94 days. Eleven patients (24%) died within 12 months of transplantation, but only one due to systemic fungal disease. Three invasive fungal infections occurred post-transplant: two relapses (one candidemia and one fatal scedosporiosis) and one new zygomycosis in a patient with previous aspergillosis. The 1-year cumulative incidence of invasive fungal disease was 6.7±3.6%. Two patients were withdrawn from the study due to treatment-related adverse events (i.e. liver toxicity). CONCLUSIONS: Voriconazole appears to be safe and effective for secondary prophylaxis of systemic fungal infection after allogeneic stem cell transplantation. The observed incidence of 6.7% (with one attributable death) is considerably lower than the relapse rate reported in historical controls, thus suggesting that voriconazole is a promising prophylactic agent in this population.


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