Micafungin prophylaxis in routine medical practice in adult and pediatric patients with hematological malignancy: a prospective, observational study in France

Diagn Microbiol Infect Dis. 2019 Jul;94(3):268-273. doi: 10.1016/j.diagmicrobio.2019.01.011. Epub 2019 Jan 26.

Abstract

This prospective, observational, multicenter study evaluated the real-world incidence of invasive fungal infection (IFI) during and after micafungin prophylaxis in France. Patients with a hematological malignancy/solid tumor received micafungin prophylaxis according to usual clinical practice and were followed for 3 months. Primary endpoint was breakthrough IFI incidence during prophylaxis. Secondary endpoints included the identification of IFI risk factors, IFI incidence during follow-up, and adverse events (AEs). One hundred and fifty patients (55 children, 95 adults) were enrolled. Micafungin prophylaxis was initiated at 50 mg in adults and at a median 1.01 mg/kg (range: 0.6-2.2) in children. Fifteen patients (10%) experienced an IFI during prophylaxis. IFI breakthrough occurred in 15% children, 7% adults, 3.1% allogeneic transplant patients, 8.7% acute myeloid leukemia (AML)/myelodysplastic syndrome (MDS) patients, 7.0% other patients (never allotransplanted/non-AML/MDS). Nineteen patients (12.7%) experienced an IFI during 3-month follow-up. Micafungin was well tolerated with few treatment-related AEs, supporting its use in this patient population in France.

Keywords: Invasive fungal infection; Micafungin, hematology; Prophylaxis; Prospective, observational, multicenter study.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antifungal Agents / administration & dosage*
  • Chemoprevention / methods*
  • Child
  • Child, Preschool
  • Drug-Related Side Effects and Adverse Reactions / epidemiology
  • Drug-Related Side Effects and Adverse Reactions / pathology
  • Female
  • France / epidemiology
  • Hematologic Neoplasms / complications*
  • Humans
  • Incidence
  • Infant
  • Invasive Fungal Infections / epidemiology*
  • Invasive Fungal Infections / prevention & control*
  • Longitudinal Studies
  • Male
  • Micafungin / administration & dosage*
  • Middle Aged
  • Prospective Studies
  • Treatment Outcome
  • Young Adult

Substances

  • Antifungal Agents
  • Micafungin