Isavuconazole Therapy for Patients with Hematologic Diseases and Hematopoietic Cell Transplantation with and Without Breakthrough Invasive Fungal Infections
2025
Fabián Herrera | Diego Torres | Gustavo Mendez | Noelia Mañez | Rosana Jordán | Adriana Manzur | Myrna Cabral | Manuel Alderete | Natalia García Allende | José Benso | Claudia Salgueira | María Laura Pereyra | Hugo Peretti | Carla Niveyro | Maximiliano Castro | Federico Pollastrelli | Silvina García Rojas | Juan Dapás | Agustina Risso Patrón | Verónica Fernández | Rocío Gago | Javier Afeltra
There are no data available on the effectiveness and safety of isavuconazole (ISA) for treating breakthrough invasive fungal infections (bIFIs). A retrospective and prospective cohort study was conducted between January 2020 and March 2025 in 13 centers in Argentina. Hematologic diseases (HD) and hematopoietic cell transplantation (HCT) patients who received ISA for IFI were included and followed for 12 weeks. Patients with proven and probable bIFIs and non-bIFIs were compared. One hundred and sixty-three patients were included. IFIs were classified as proven (13.5%), probable (26.9%) and possible (59.5%). Among 66 proven and probable IFIs, 53% were bIFIs, with aspergillosis and mucormycosis being the most common. Twenty-three (34.8%) patients had acute myelogenous leukemia, and 40.9% had received HCT. Forty-eight (72.7%) patients experienced neutropenia, with a median duration of 26 days (interquartile range [IQR] 16–44). Fluconazole and posaconazole were the most frequently received antifungal prophylaxis. ISA was prescribed as first-line therapy in 31 (46.9%) patients. The other 35 received ISA as a continuation therapy, mainly as a step-down therapy after liposomal amphotericin B. Four (6.1%) patients developed adverse effects, and one discontinued ISA. The 90-day overall clinical response between patients with bIFI vs. non-bIFI was 91.4% vs. 70.9% (<i>p</i> = 0.052). The 90-day overall and IFI-related mortality rates were, respectively, 11.4% vs. 32.3% (<i>p</i> = 0.068) and 5.7% vs. 9.7% (<i>p</i> = 0.659). The study data evidence ISA effectiveness and safety for the treatment of HD and HCT patients with and without bIFIs.
Show more [+] Less [-]Bibliographic information
This bibliographic record has been provided by Directory of Open Access Journals