Transpl Infect Dis:同种异体SCT后抗真菌预防,氟康唑的理想剂量 你造吗?

2018-09-05 王淳 环球医学

侵袭性真菌感染(IFI)是同种异体干细胞移植(同种异体SCT)一种常见的副作用,会增加非复发性死亡率(NRM)并降低总存活(OS)率。75日氟康唑400 mg/d是同种异体SCT后的标准初级抗真菌预防(PAP)方案,尤其是低风险移植。但是,氟康唑的理想剂量还未被考察。2018年8月,发表在《Transpl Infect Dis》的一项研究对此进行分析。

侵袭性真菌感染(IFI)是同种异体干细胞移植(同种异体SCT)一种常见的副作用,会增加非复发性死亡率(NRM)并降低总存活(OS)率。75日氟康唑400 mg/d是同种异体SCT后的标准初级抗真菌预防(PAP)方案,尤其是低风险移植。但是,氟康唑的理想剂量还未被考察。2018年8月,发表在《Transpl Infect Dis》的一项研究对此进行分析。

本文中,研究人员报道了所在机构在1999至2015年间,连续的113名接受HLA相同同胞的同种异体干细胞移植的患者,PAP包括仅移植前的氟康唑100 mg/d。移植时,根据ECIL-5指南,所有患者被评为低风险的霉菌感染

结果显示,移植后100日,可能-很可能-证实的IFI累积发生率是11.7%,而5.5%患者出现证实-很可能的IFI(PP-IFI)。值得注意的,仅1名患者出现非白色菌珠导致的侵袭性念珠菌病,并且粪便检测显示白色念珠菌定植阴性。1年急性和2年慢性移植物抗宿主病(GVHD)的发病率分别是30%和45%。3年OS和1年NRM分别是53%和11.3%。

总体上,氟康唑100 mg/d的真菌预防能降低低风险同种异体SCT的PP-IFI、GVHD和NRM的发生率。

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    2019-07-13 amy0563
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    2018-09-27 bsmagic9140
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    2018-09-07 zhaojie88
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