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Updated: Oct 23, 2025

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Clinical Considerations of Isavuconazole Administration in High-Risk Hematological Patients: A Single-Center 5-Year

Ilona Kronig1, Stavroula Masouridi-Levrat2, Yves Chalandon2

  • 1Division of Infectious Diseases, University Hospital of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva, Switzerland.

Mycopathologia
|August 25, 2021
PubMed
Abstract

Insights

Isavuconazole is a safe antifungal for hematological patients, showing reduced liver enzymes and QTc interval shortening. This real-world study confirms its efficacy in preventing and treating invasive mold infections (IMI).

Area of Science:

  • Mycology
  • Hematology
  • Pharmacology

Background:

  • Limited real-world data exists on isavuconazole for invasive mold infections (IMI) in hematological patients and allogeneic hematopoietic cell transplant (HCT) recipients.
  • Isavuconazole is a broad-spectrum triazole antifungal agent.

Purpose of the Study:

  • To describe real-world indications for isavuconazole use in a university hospital.
  • To evaluate liver function tests, QTc interval, clinical outcomes, and breakthrough IMI during isavuconazole therapy.

Main Methods:

  • A 5-year retrospective study (June 2016 - July 2020) of adult hematological patients and HCT recipients receiving isavuconazole.
  • Data collected included indications for use, laboratory values, QTc interval, and clinical outcomes.

Main Results:

  • Isavuconazole was administered for adverse events of prior antifungals (60%), clinical efficacy (16.6%), and other reasons (33.3%).
  • Significant decreases in alanine aminotransferase and QTc interval were observed.
  • No breakthrough invasive mold infections (IMI) occurred.

Conclusions:

  • Isavuconazole demonstrates safety and reliability in complex hematological patients.
  • The agent exhibits favorable properties, including low hepatotoxicity and QTc interval shortening.
Keywords:
Acute myelogenous leukemiaAllogeneic hematopoietic cell transplant recipientsInvasive mold infectionsIsavuconazoleProphylaxisTreatment

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