Fungal pathogens and primary antifungal prophylaxis in patients with hematological malignancies: one year experience

H Gedik, MT Yildirmak, F Simsek, D Aydin, N Demirel, O Yokus, D Arica

Abstract

Background: Febrile neutropenia (FN) is generally a complication of cancer chemotherapy in patients with hematological malignancies.

Objective: To evaluate the febrile neutropenia episodes of hematological patients and their outcomes with respect to fungal pathogens, primary antifungal prophylaxis antifungal therapy.

Methods: All consecutive patients older than 14 years of age and who developed febrile neutropenia episodes from September 2010 to November 2011 were incorporated into this study.

Results: In total, we retrospectively evaluated 86 consecutive patients and their 148 neutropenic episodes. Of the 86 patients, 45 were male and the mean age was 47,65±15,06 years (range: 17–82 years). The mean MASCC score was 18,72 ± 9,43. Systemic antifungal drug was initiated to 17 patients with probable fungal infection and 12 patients with possible fungal infection. Of seven patients who received posaconazole prophylaxis, five were treated with systemic fungal infection due to possible fungal infection.

Conclusions: It is obvious that more studies focused on primary prophylaxis are needed and primary or secondary antifungal prophylaxis should be evaluated in terms of provided benefits and disadvantages. Timely and appropriately initiated antifungal treatment is one of the most important factors for a good prognosis for recovery from a neutropenic phase.

Key words: Hematological patients, febrile neutropenia, antifungal prophylaxis, antifungal treatment