title: [Itraconazole capsules as antifungal prophylaxis for neutropenic patients with hematological malignancies from a single institution].
abstract: We have previously reported that itraconazole (ITCZ) at a dose of 200 mg/day is more effective than ITCZ at a dose of 100 mg/day and is safe for prophylaxis of mycosis. In this prospective study, 37 patients with hematological malignancies were administered 200 mg/day of ITCZ for prophylaxis of mycosis during neutropenia. Although none of the patients developed mycosis, 31 patients (83.8%) of the ITCZ administered patients developed neutropenia (neutrophil < 1000/microL), and 12 patients of them showed the possibility of fugitive fungal infection. The prolonged neutropenia and low neutrophil level were observed in the patients with malignant lymphoma at stage III-IV, which suggested the necessity of prophylactic antifungal drugs. Four patients showed the adverse events which might be caused by drug interactions between ITCZ and vinca alkaloid. However adequately modified administration of ITCZ prevented these effect. There were no other obvious side effects which were supposed to be caused by prophylactic ITCZ administration. Twenty-eight patients were measured plasma concentration of ITCZ about 10 days after the beginning of administration and mean trough ITCZ level was expected to be above the effective level (250 ng/ml). These results suggested that ITCZ is effective and safe for prophylaxis of mycosis during neutropenia in patients with hematological malignancies.
authors.affiliation: Department of Hematology and Oncology, Hokkaido University Graduate School of Medicine.
authors.forename: Tomomi
authors.initials: T
authors.lastname: Toubai
authors.forename: Junji
authors.initials: J
authors.lastname: Tanaka
authors.forename: Shuichi
authors.initials: S
authors.lastname: Ota
authors.forename: Naoko
authors.initials: N
authors.lastname: Kato
authors.forename: Shintaro
authors.initials: S
authors.lastname: Umehara
authors.forename: Kaoru
authors.initials: K
authors.lastname: Kahata
authors.forename: Nobuyasu
authors.initials: N
authors.lastname: Toyoshima
authors.forename: Masahiro
authors.initials: M
authors.lastname: Asaka
authors.forename: Masahiro
authors.initials: M
authors.lastname: Imamura
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002214:Capsules; D004347:Drug Interactions; D005260:Female; D006801:Humans; D017964:Itraconazole / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood; D007938:Leukemia / Q000150:complications*; D008223:Lymphoma / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications; D009181:Mycoses / Q000517:prevention & control*; D009503:Neutropenia / Q000150:complications*; D011446:Prospective Studies
chemical_list: D002214:Capsules; D017964:Itraconazole