Antifungal prophylaxis for patients with hematologic diseases in Seoul St. Mary’s Hospital (last revised January 2022).
| Type of patients | Primary | Alternative |
|---|---|---|
| AML Induction/reinduction chemotherapya) | Posaconazole (T) | Posaconazole (S) |
| Fluconazole | ||
| HMA/Venetoclasa) | ||
| - Secondary/refractory AML | Posaconazole (T) | Posaconazole (S) |
| - Relapsed AML (only in 1st and 2nd cycle) | Posaconazole (T) | Fluconazole |
| - Otherwise | Fluconazole | |
| Other chemotherapy (neutropenia >7 days)a) | Fluconazole | |
| Auto-HSCTa),c) | Micafungin | Fluconazole |
| Itraconazole | ||
| Allo-HSCT (pre-engraftment)a),c) | Micafungin | Itraconazole (S) |
| Allo-HSCT (in the presence of GVHD)b) | Posaconazole (T) | Posaconazole (S) |
| Fluconazole |
a)Start from absolute neutrophil count ≤1,000 until resolution of neutropenia. b)Until at least 75 days from start or resolution of significant GVHD. c)Voriconazole is only used as secondary prophylaxis in patients with previous proven or probable IPA history.
Abbreviations: AML, acute myeloid leukemia; GVHD, graft versus host disease; HMA, hypomethylating agent; HSCT, hematopoietic stem cell transplantation; S, Syrup; T, Tablet.
Blood Res 2022;57:S101~S111 https://doi.org/10.5045/br.2022.2022036
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