A retrospective analysis of micafungin prophylaxis in children under 12 years undergoing chemotherapy or hematopoietic stem cell transplantation Journal Article

   


Authors: Goscicki, B. K.; Yan, S. Q.; Mathew, S.; Mauguen, A.; Cohen, N.
Article Title: A retrospective analysis of micafungin prophylaxis in children under 12 years undergoing chemotherapy or hematopoietic stem cell transplantation
Abstract: OBJECTIVES Literature is limited regarding ideal micafungin dosing in pediatric patients with hematologic malignancies receiving chemotherapy or hematopoietic stem cell transplantation. Micafungin is an intravenous echinocandin with activity against Candida and Aspergillus species and has a favorable safety profile compared with other antifungal classes. Our objective was to evaluate the breakthrough invasive fungal infection (IFI) rate in pediatric patients who received a prophylactic micafungin course at our institution. METHODS A single-center, retrospective study was conducted between January 1, 2011, and July 31, 2017, to determine the IFI rate in patients receiving micafungin prophylaxis. Patients with suspected IFI were evaluated for probable or proven infection based on European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group Consensus Group invasive fungal disease definitions. Statistical analyses were descriptive. RESULTS A total of 170 prophylactic micafungin courses from 129 unique patients ages <12 years at a me-dian dose of 3 mg/kg daily were identified. The rate of probable or proven breakthrough IFIs was 2.4% as determined by clinical, radiologic, microbiologic, and histopathologic criteria. CONCLUSIONS A low rate of breakthrough IFI was seen with micafungin prophylaxis that is consistent with prior published adult hematopoietic stem cell transplantation studies. Micafungin was well tolerated, with liver function test elevations being transient in most cases and thought to be related to alternative factors. ABBREVIATIONS FDA, US Food and Drug Administration; GVHD, graft-versus-host disease; HSCT, hematopoietic stem cell transplantation; IFI, invasive fungal infection; IV, intravenous; LFT, liver function test; PK, pharmacokinetics. © Pediatric Pharmacy Association. All rights reserved.
Keywords: child; major clinical study; neutropenia; chemotherapy; cohort analysis; creatinine; hematopoietic stem cell transplantation; oncology; retrospective study; risk factor; acute lymphoblastic leukemia; alanine aminotransferase; aspartate aminotransferase; bilirubin; hematologic malignancy; infant; prophylaxis; newborn; graft versus host reaction; single drug dose; allogeneic hematopoietic stem cell transplantation; liver function test; immune deficiency; corticosteroid; children; aspergillus fumigatus; micafungin; pediatrics; platelet count; hematology; lung lavage; transplant; systemic mycosis; acute myeloid leukemia; antifungal therapy; antifungal prophylaxis; candida parapsilosis; fungemia; human; female; article; absolute neutrophil count; breakthrough infection; breakthrough invasive fungal infection; rhodotorula mucilaginosa
Journal Title: Journal of Pediatric Pharmacology and Therapeutics
Volume: 29
Issue: 4
ISSN: 1551-6776
Publisher: Pediatric Pharmacy Advocacy Group, Inc.  
Date Published: 2024-01-01
Start Page: 379
End Page: 384
Language: English
DOI: 10.5863/1551-6776-29.4.379
PROVIDER: scopus
PMCID: PMC11321804
PUBMED: 39144392
DOI/URL:

https://www.scopus.com/inward/record.uri?eid=2-s2.0-85202072569&doi=10.5863%2f1551-6776-29.4.379&partnerID=40&md5=34a3a49ac340efef01363293cbcc208c
Notes: The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PubMed record and PDF -- Source: Scopus
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MSK Authors
  1. Sherry Mathew
    19 Mathew
  2. Nina Cohen Orsini
    32 Cohen Orsini
  3. Qiong Yan
    10 Yan
  4. Audrey Mauguen
    155 Mauguen
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