Background: Invasive aspergillosis is an important cause of morbidity and mortality in neutropenic patients after chemotherapy in hematologic malignancies. HEPA filtration
was known as an effective preventivs measurs for invasive aspergillosis, but the role of chemoprophylaxis has not been established yet. Itraconazols has been considered to be
an effective antifungal agent for invasive aspergillosis. We evaluated the effect of itraconazole chemoprophylaxis in the prevention of invasive aspergillosis for neutropenic
patients after chemotherapy in hematologic malignancies, who were treated in general ward without HEPA filtration.
Methods: A total of 89 patients with hematologic malignancies were enrolled in the two groups between January, 1995 and December, 1997 at Samsung medical center.
Itraconazole, 200 ㎎ po twice daily, was given to the patients as their neutrophil count decreased below 1,000/μL following chemotherapy, and continued until it recovered over 1,000/μL. Incidence of invasive aspergillosis was prospectively compared between the itraconazole prophylaxis group and the control group.
Results: Itraconazols prophyaxis was dons in 34 patients on a total 59 episodes of severe neutropenia(absolute neutrophil count <500/μL) after chemotherapy. Two out of
34 patients were histologically diagnosed as invasive aspsrgillosis. Control group included 55 patients with 103 episodes of severs neutropenia. Five out of 55 patients were
diagnosed as invasive aspergillosis. No statistically significant differences were observed between two groups, because 2 of 59(3.4%) and 5 of 103(4.9%) wsre found to have
invasive aspergillosls proven histologically(P=1.00).
Conclusion: Itraconazole chemoprophylaxis for invasive aspergillosis was not effective, and the prognosis was closely related to the recovery of neutrophils. But we cannot exclude the possibility that the drug has been failed in achieving affective plasma concentration by oral administration, as reported in several studies. Randomized
prospective study, including measursment of plasma drug concentration, is warranted to evaluate the efficacy of itraconazols for the prevention of invasive aspergillosis.

Keywords: Aspsrgillosis, Itraconazols, Prophylactic, Neutropenia