Abstract:

Purpose: The mortality of invasive fungal infections (IFE) developing in patients diagnosed with acute Myeloid Lusemia (AML) and receiving remission-inductive chemotherapy is high. The use of antifungal prevention is recommended in these patients, but there is no clear information about the time of starting antifungal prevention. In this study, in patients receiving remission-inductive chemotherapy, the effectiveness of antifungal prevention begun with chemotherapy and the effectiveness of posaconazole prevention begun after the patient entered the neutropenia. In patients with AML diagnosis and remission induction chemotherapy, the differences between posaconazole prevention (Group 1) and posaconazole prevention (Group 2) began after entering the neutropenia were compared with the chemotherapy regime. The demographic data of the patients and developing IFEs were recorded. Results: During the study, 104 patients received remission induction chemotherapy with the diagnosis of AML were taken to study. In the first group there were 46 patients and in the second group there were 58 patients. In comparison with the preventive effectiveness, 22 patients in the first group (47.8%) in the second group (19 (32.8) were disadvantaged. The demographic data of both groups were similar, but the presence of neutropene over 21 days was found more in group 1. Also, the average time of neutropene in group 1 was longer (p<0.001). Result: In Group 2, which began with chemotherapy for the prevention of posaconazole, the frequency of IFE was 22.4%. Although there is a difference between the patient’s characteristics between both groups, antifungal prevention started with chemotherapy has been believed to be more effective in preventing the development of IFE. Because the time of posaconazole achieving a serum-stable state concentration is 6-10 days. In patients starting with posaconazole, posaconazole will have achieved an effective concentration during the period in which the patient is at risk for IFE.

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