title: Posaconazole prophylaxis during front-line chemotherapy of acute myeloid leukemia: a single-center, real-life experience.
abstract: BACKGROUND
  Posaconazole is effective as primary antifungal prophylaxis of invasive fungal diseases in patients with acute myeloid leukemia.
  
  
  METHODS
  The impact of primary antifungal prophylaxis administered during front-line chemotherapy for acute myeloid leukemia was evaluated by comparing 58 patients who received oral amphotericin B (control group) to 99 patients who received oral posaconazole (posaconazole group). The primary endpoint was the incidence of proven/probable invasive fungal diseases. Secondary endpoints included incidence of invasive aspergillosis, survival at 4 and 12 months after the diagnosis of acute myeloid leukemia and costs.
  
  
  RESULTS
  Proven/probable invasive fungal diseases were documented in 51.7% of patients in the control group and in 23.2% in the posaconazole group (P=0.0002). Invasive aspergillosis was documented in 43% of patients in the control group and in 15% in the posaconazole group (P=0.002). No survival difference was observed in patients aged over 60 years. In patients aged 60 years or less, a statistically significant survival advantage was observed at 4 months, but no longer at 12 months, in the posaconazole group (P=0.03). It was calculated that in the posaconazole group there was a mean 50% cost reduction for the antifungal drugs.
  
  
  CONCLUSIONS
  Primary antifungal prophylaxis with posaconazole during front-line chemotherapy was effective in preventing invasive fungal diseases in a "real-life" scenario of patients with acute myeloid leukemia, resulted in an early but transitory survival advantage in younger patients and was economically advantageous.
authors.affiliation: Dipartimento di Ematologia, Oncologia, Anatomia Patologica e Medicina Rigenerative, Azienda Policlinico Umberto I, Sapienza University of Rome Via Benevento 6, 00161 Rome, Italy. girmenia@bce.uniroma1.it
authors.forename: Corrado
authors.initials: C
authors.lastname: Girmenia
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Frustaci
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Gentile
authors.forename: Clara
authors.initials: C
authors.lastname: Minotti
authors.forename: Claudio
authors.initials: C
authors.lastname: Cartoni
authors.forename: Saveria
authors.initials: S
authors.lastname: Capria
authors.forename: Silvia Maria
authors.initials: SM
authors.lastname: Trisolini
authors.forename: Angela
authors.initials: A
authors.lastname: Matturro
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Loglisci
authors.forename: Roberto
authors.initials: R
authors.lastname: Latagliata
authors.forename: Massimo
authors.initials: M
authors.lastname: Breccia
authors.forename: Giovanna
authors.initials: G
authors.lastname: Meloni
authors.forename: Giuliana
authors.initials: G
authors.lastname: Alimena
authors.forename: Robin
authors.initials: R
authors.lastname: Foà
authors.forename: Alessandra
authors.initials: A
authors.lastname: Micozzi
mesh_terms: D000328:Adult; D000368:Aged; D019072:Antibiotic Prophylaxis; D000935:Antifungal Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D005260:Female; D006760:Hospitalization / Q000191:economics; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000150:complications* / Q000188:drug therapy / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000191:economics / Q000209:etiology* / Q000517:prevention & control*; D016019:Survival Analysis; D016896:Treatment Outcome; D014230:Triazoles / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D000935:Antifungal Agents; D014230:Triazoles; C101425:posaconazole
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