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- Title
Serum posaconazole levels during acute myeloid leukaemia induction therapy: correlations with breakthrough invasive fungal infections.
- Authors
Cattaneo, Chiara; Panzali, Annafranca; Passi, Angela; Borlenghi, Erika; Lamorgese, Cinzia; Petullà, Marta; Re, Alessandro; Caimi, Luigi; Rossi, Giuseppe
- Abstract
The usefulness of posaconazole therapeutic drug monitoring ( TDM) is still a matter of debate. A correlation between posaconazole serum levels and breakthrough invasive fungal infections ( IFI) has not been clearly demonstrated so far. We analysed posaconazole serum levels in patients with acute myeloid leukaemia ( AML) during induction therapy and correlated them with the incidence of breakthrough IFI and the need of systemic antifungal therapy. Overall, 77 AML patients receiving posaconazole were evaluated for serum levels; breakthrough IFI were observed in five with at least one posaconazole TDM (6.5%). Median serum level was 534 ng ml−1 ( IQ range: 298.5-750.5 ng ml−1) and did not change significantly over time. Four of the 40 patients with median posaconazole levels <500 ng ml−1 developed IFI, as compared with only 1 of the 37 patients with median levels ≥500 (10% vs. 2.7%, P = 0.19). Median posaconazole levels on day 7 were 384.5 ng ml−1 ( IQ range: 207-659 ng ml−1) and 560.5 ng ml−1 ( IQ range: 395-756 ng ml−1) in patients requiring or not systemic antifungal treatment respectively ( P = 0.067). These results seem to confirm that higher median serum levels of posaconazole correlate with higher prophylactic efficacy against proven/probable IFI and with lesser need of systemic antifungal therapy.
- Subjects
ANTIFUNGAL agents; COMMUNICABLE disease treatment; MYCOSES; ACUTE myeloid leukemia; DRUG monitoring; VORICONAZOLE; PATIENTS; BREAKTHROUGH infections
- Publication
Mycoses, 2015, Vol 58, Issue 6, p362
- ISSN
0933-7407
- Publication type
Article
- DOI
10.1111/myc.12326