Voriconazole for prophylaxis of invasive fungal infections after allogeneic hematopoietic stem cell transplantation.
Invasive fungal infections (IFIs) following allogeneic hematopoietic stem cell transplantation (alloHSCT) are associated with a high mortality, and accordingly most alloHSCT recipients receive prophylaxis with antifungal agents. Despite some improvement in outcomes of IFIs over time, they continue to represent substantial clinical risk, mortality, and financial burden. Areas covered: We review the main pathogens responsible for IFIs in recipients of alloHSCT, current treatment recommendations, and discuss clinical and economic considerations associated with voriconazole prophylaxis of IFIs in these patients. Expert commentary: The clinical efficacy of voriconazole appears to be at least equivalent to other antifungal treatments, and generally well tolerated. Overall, benefit-risk balance is favorable, and findings from cost-effectiveness analyses support the use of voriconazole prophylaxis of IFIs in recipients of alloHSCT.
a Adult BMT Unit, Bristol Haematology and Oncology Centre , University Hospitals Bristol NHS Foundation Trust , Bristol , UK.
David I
DI
Marks
b Department of Hematology , Nanfang Hospital, Southern Medical University , Guangzhou , China.
Qifa
Q
Liu
c Department of Infectious Diseases , Victorian Infectious Diseases Service, Royal Melbourne Hospital , Melbourne , Australia.
Monica
M
Slavin
D000935:Antifungal Agents / Q000191:economics* / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D004334:Drug Administration Schedule; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D000072742:Invasive Fungal Infections / Q000209:etiology / Q000276:immunology / Q000382:microbiology / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D011322:Primary Prevention; D014184:Transplantation, Homologous; D014230:Triazoles / Q000191:economics* / Q000627:therapeutic use; D065819:Voriconazole / Q000191:economics* / Q000627:therapeutic use
D000935:Antifungal Agents; D014230:Triazoles; C101425:posaconazole; D065819:Voriconazole
Allogeneic hematopoietic stem cell transplantation; invasive aspergillosis; invasive candidiasis; prophylaxis; triazoles; voriconazole