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Voriconazole Antifungal Prophylaxis in Children With Malignancies: A Nationwide Study

Zoi Dorothea Pana1,2, Maria Kourti3, Katerina Vikelouda1

  • 1Infectious Diseases Unit, 3rd Department of Pediatrics, Faculty of Medicine, Aristotle University School of Health Sciences.

Journal of Pediatric Hematology/Oncology
|August 18, 2017
PubMed

Insights

Antifungal prophylaxis with voriconazole (VRC) is safe for pediatric hematology-oncology patients. This study found VRC well-tolerated with manageable adverse events, supporting its use in this vulnerable population.

Area of Science:

  • Pediatric Hematology-Oncology
  • Infectious Disease Prevention
  • Pharmacovigilance

Background:

  • Antifungal prophylaxis (AFP) is crucial for immunocompromised pediatric patients undergoing cancer treatment.
  • Voriconazole (VRC) is a broad-spectrum antifungal agent used for prophylaxis.
  • Evaluating VRC safety in pediatric hematology-oncology patients is essential.

Purpose of the Study:

  • To assess the safety and tolerability of voriconazole (VRC) as antifungal prophylaxis (AFP) in pediatric patients with hematologic malignancies.
  • To identify and characterize adverse events associated with VRC use in this population.

Main Methods:

  • Retrospective study conducted across 7 Greek pediatric hematology-oncology centers (2008-2012).
  • Inclusion of 249 pediatric patients (median age 6 years) receiving VRC AFP.
  • Data collection on demographics, underlying diseases, VRC dosage, duration, and adverse events.

Main Results:

  • 429 VRC AFP courses were analyzed; common diagnoses included acute lymphoblastic leukemia (51%).
  • Most common adverse events were elevated liver enzymes (50% of AEs), hypokalemia (24.3%), and ophthalmological disorders (14.3%).
  • Only one breakthrough fungemia and one death due to underlying disease were reported, indicating good overall outcomes.

Conclusions:

  • Voriconazole (VRC) antifungal prophylaxis (AFP) is well-tolerated in pediatric hematology-oncology patients.
  • The observed adverse events were generally mild to moderate and manageable.
  • VRC represents a safe prophylactic option for this high-risk patient group.
Abstract

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