Evaluation of the practice of antifungal prophylaxis use in patients with newly diagnosed acute myeloid leukemia: Results from the SEIFEM 2010-B registry

Abstract

Background.To analyze the efficacy of antifungal prophylaxis (AFP) with posaconazole and itraconazole in a real-life setting of patients with acute myeloid leukemia (AML) during the first induction of remission.Methods.From January 2010 to June 2011, all patients with newly diagnosed AML were consecutively registered and prospectively monitored at 30 Italian hematological centers. Our analysis focused on adult patients who received intensive chemotherapy and a mold-active AFP for at least 5 days. To determine the efficacy of prophylaxis, invasive fungal disease (IFD) incidence, IFD-attributable mortality, and overall survival were evaluated.Results.In total, 515 patients were included in the present analysis. Posaconazole was the most frequently prescribed drug (260 patients [50]) followed by fluconazole (148 [29]) and itraconazole (93 [18]). When comparing the groups taking posaconazole and itraconazole, there were no significant differences in the baseline clinical characteristics, whereas there were significant differences in the percentage of breakthrough IFDs (18.9 with posaconazole and 38.7 with itraconazole, P