Efficacy and Safety of Micafungin as Prophylaxis for Invasive Fungal Disease in Neutropenic Patients with Hematologic Malignancies

Invasive Fungal Disease (IFD) is a major cause of death in severe neutropenic patients with hematologic malignancies. Micafungin, a new echinocandin antifungal drug, is effective in treating IFD. However, the efficacy and safety of micafungin in preventing IFD in severe neutropenic patients with hematologic malignancies have not been demonstrated. A prospective and multicenter clinical study was conducted to evaluate the efficacy and safety of micafungin as prophylaxis for IFD. Micafungin 50 mg daily was administered intravenously to 117 high-risk patients with hematologic malignancies undergoing intensive chemotherapy or Hematopoietic Stem Cell Transplantation (HSCT), for a median of 24 days. Successful prophylaxis (no proven, probable or possible IFD up to 1 week after the end of prophylactic treatment) was achieved in 88.54% patients. No patient developed proven IFD during treatment and only 2.08% had probable IFD and 9.38% possible IFD. Micafungin potentially accounted for adverse events in 6.84% of patients. No severe adverse events attributable to micafungin were seen. Micafungin 50 mg daily is a promising prophylactic antifungal therapy for neutropenic patients with hematologic malignancies.