Retrospective comparison of Micafungin versus Voriconazole during primary antifungal prophylaxis in patients with hematological malignancies undergoing allogeneic HSCT.

Abstract

Background: Invasive fungal infections (IFI) are the cause of significant morbidity and mortality in patients undergoing hematopoietic stem cell transplantation (HSCT). Early diagnosis of IFI is challenging while a delay in antifungal therapy may increase mortality. Therefore, prophylactic use of several anti-fungal agents were recommended. The aim of the study was to compare the efficiency of Micafungin and Voriconazole for prophylaxis of fungal infections in a retrospective analysis study. Methods: Of the patients undergoing allogeneic HSCT due to hematologic malignancies in our institution between 2011 and 2014, thirty patients receiving Micafungin for antifungal prophylaxis were compared with thirty patients receiving Voriconazole. Primary endpoint was the occurrence of the breakthrough IFI during antifungal treatment. Secondary endpoints were fungal colonizations. β-D-Glucan level, Galactomannan (GM) levels, voriconazole plasma levels were measured. Results: Two groups of patients were comparable in demographic parameters and diagnosis distribution. One case of the possible IFI was diagnosed in the Micafungin group and one in the Voriconazole group. Two cases of fungal colonization were diagnosed in the Micafungin group and two cases in the Voriconazole group. In all cases oropharynx was the colonization place. Conclusions: both medicines were efficient in prophylaxis of fungal infections in HSCT patients. No cases of breakthrough infections were detected.

Datum der Bewilligung	2025
Originalsprache	Englisch
Gradverleihende Hochschule	Medizinische Universität Graz
Betreuer/-in	Peter Neumeister (Betreuer*in) & Katharina Prochazka (Betreuer*in)