International Journal of Hematology

, Volume 85, Issue 2, pp 121–127

The prophylactic effect of itraconazole capsules and fluconazole capsules for systemic fungal infections in patients with acute myeloid leukemia and myelodysplastic syndromes: a japanese multicenter randomized, controlled study

  • Yoshikazu Ito
  • Kazuma Ohyashiki
  • Isao Yoshida
  • Makoto Takeuchi
  • Yasutaka Aoyama
  • Atsuko Mugitani
  • Yasuhiro Matsuura
  • Hisashi Wakita
  • Mitsuhiro Matsuda
  • Erina Sakamoto
  • Toru Kiguchi
  • Akio Urabe
  • Kazuo Tamura
  • Akihisa Kanamaru
  • Toru Masaoka
  • The Japan Febrile Neutropenia Study Group
Article

DOI: 10.1532/IJH97.06079

Cite this article as:
Ito, Y., Ohyashiki, K., Yoshida, I. et al. Int J Hematol (2007) 85: 121. doi:10.1532/IJH97.06079

Abstract

We performed a randomized, controlled study comparing the prophylactic effects of capsule forms of fluconazole (n = 110) and itraconazole (n = 108) in patients with acute myeloid leukemia (AML) or myelodysplastic syndromes (MDS) during and after chemotherapy.There were 4 cases with possible systemic fungal infection in the itraconazole group, and there were 8 possible and 3 probable cases in the fluconazole group. Adverse events did not significantly differ in the 2 groups. In patients with MDS or in the remission-induction phase of chemotherapy, the numbers of cases with probable or possible infections were lower in the itraconazole group than in the fluconazole group, whereas no difference was seen in patients with AML or in the consolidation phase of therapy. In patients with neutrophil counts of <0.1 * 109/L lasting for more than 4 weeks, the frequency of infection in the fluconazole group (5 of 9 patients) was significantly higher than in the itraconazole group (0 of 7 patients; P = .03). Our results suggest that both drugs were well tolerated in patients with AML or MDS who received chemotherapy and that the efficacy of itraconazole for prophylaxis against systemic fungal disease is not inferior to that of fluconazole.

Key words

Acute myeloid leukemiaMyelodysplastic syndromesChemotherapyFungal infectionProphylaxis

Copyright information

© The Japanese Society of Hematology 2007

Authors and Affiliations

  • Yoshikazu Ito
  • Kazuma Ohyashiki
    • 1
  • Isao Yoshida
    • 1
  • Makoto Takeuchi
    • 2
  • Yasutaka Aoyama
    • 2
  • Atsuko Mugitani
    • 3
  • Yasuhiro Matsuura
    • 4
  • Hisashi Wakita
    • 4
  • Mitsuhiro Matsuda
    • 5
  • Erina Sakamoto
    • 6
  • Toru Kiguchi
    • 7
  • Akio Urabe
    • 8
  • Kazuo Tamura
    • 9
  • Akihisa Kanamaru
    • 5
  • Toru Masaoka
    • 10
  • The Japan Febrile Neutropenia Study Group
  1. 1.First Department of Internal Medicine (Hematology Division)Tokyo Medical UniversityShinjuku-ku, TokyoJapan
  2. 2.Department of Internal MedicineNational Hospital Organization Minami-Okayama Medical CenterOkayamaJapan
  3. 3.Department of HematologyFuchu HospitalIzumiJapan
  4. 4.Department of Internal MedicineNarita Red Cross HospitalNaritaJapan
  5. 5.Department of HematologyKinki University School of MedicineOsaka-SayamaJapan
  6. 6.Department of Clinical Hematology and Clinical DiagnosticsGraduate School of Medicine, Osaka City UniversityOsakaJapan
  7. 7.Department of Internal MedicineKagawa Rosai HospitalMarugameJapan
  8. 8.Division of HematologyNTT Kanto Medical CenterTokyoJapan
  9. 9.First Department of Internal MedicineSchool of Medicine, Fukuoka UniversityFukuokaJapan
  10. 10.Osaka Medical Center for Cancer and Cardiovascular DiseasesOsakaJapan