Evaluation of the Use of Micafungin in the Field of Hematology and Future Issues

Accession number;04A0212055
Title;Evaluation of the Use of Micafungin in the Field of Hematology and Future Issues
Author; SHIMOEDA SADAHIKO (Naganosekijujibyoin Yakuzaibu) OTA SHIN (Naganosekijujibyoin Yakuzaibu) KOBAYASHI HIKARU (Nagano Red Cross Hospital, JPN) SAITO HIROSHI (Nagano Red Cross Hospital, JPN) SATO CHIZURU (Niigata Univ. Pharmacy and Applied Life Sci., JPN) EBARA KEIKO (Niigata Univ. Pharmacy and Applied Life Sci., JPN) YAMATO SUSUMU (Niigata Univ. Pharmacy and Applied Life Sci., JPN) TANAKA MUTSUKO (Niigata Univ. Pharmacy and Applied Life Sci., JPN) KAWANO KENJI (Niigata Univ. Pharmacy and Applied Life Sci., JPN)
Journal Title;Japanese Journal of Pharmaceutical Health Care and Sciences
Journal Code:Y0888A
ISSN:1346-342X
VOL.30;NO.3;PAGE.203-210(2004)
Figure&Table&Reference;FIG.3, TBL.4, REF.15
Pub. Country;Japan
Language;Japanese
Abstract;We evaluated the usage, effectiveness, and adverse reactions of micafungin (MCFG) in 17 patients with hematological disorders(6 with acute myelocytic leukemia, 2 with chronic myelocytic Ieukemia, 3 with aplastic anemia, 4 with myelodysplastic syndrome, 1 with multiple myelomas, and 1 with myelofibrosis) being treated in our hospital. Complete remission was achieved in 1 patient, and stabilization in 7, but the condition of 5 became aggravated. Three patients were excluded due to the administration of prophylactics and effectiveness could not be determined in 1 patient. For 9 patients with definite or suspected pulmonary aspergillosis, MCFG was effective in 3 of 4 treated at a dose of 150 mg and in 2 of 5 treated at a dose of 75 mg. The administration of MCFG was discontinued due to adverse reactions and associated symptoms in 7 patients (drug-induced fever in 3, nausea/vomiting in 2, abnormal liver function in 2, drug eruption in 1, and diarrhea in 1; including patients with more than 1 symptom). All adverse reactions and associated symptoms were mild in degree, however. From the above observations, we concluded that in the case of administering MCFG for pulmonary aspergillosis, a daily dose of 75 mg is inadequate and a daily dose of 150 mg or more is necessary. Our findings also suggested that for patients who do not respond to conventional antifungal drugs or cannot be treated with an adequate dose of such drugs due to adverse reactions, the high-dose administration of MCFG together with amphotericin B may be effective. (author abst.)