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Rethinking the definition of 'less intensive' for venetoclax-combining regimens in acute myeloid leukaemia patients

E Borlenghi1, A M Roccaro2, C Cattaneo1

  • 1Hematology, ASST Spedali Civili, Brescia, Italy.

British Journal of Haematology
|October 7, 2023
PubMed

Insights

Posaconazole prophylaxis may reduce invasive fungal infections (IFIs) in acute leukaemia patients treated with venetoclax and chemotherapy. This study suggests monitoring posaconazole levels, though a direct link to IFI risk needs further investigation.

Area of Science:

  • Hematology
  • Infectious Diseases
  • Pharmacology

Background:

  • Invasive fungal infections (IFIs) pose a significant threat to patients with acute leukaemia.
  • Pulmonary aspergillosis is a common and serious IFI in this vulnerable population.
  • Existing treatments carry risks and necessitate careful management.

Purpose of the Study:

  • To evaluate the impact of posaconazole prophylaxis on IFI incidence in acute leukaemia patients.
  • To assess the safety and efficacy of co-administering posaconazole with venetoclax-based regimens.
  • To explore the role of therapeutic drug monitoring for posaconazole.

Main Methods:

  • Retrospective analysis of patient data.
  • Inclusion of patients receiving venetoclax plus hypomethylating agents or chemotherapy.
  • Administration of posaconazole for prophylaxis.

Main Results:

  • Posaconazole prophylaxis was associated with a reduced incidence of IFIs.
  • No direct correlation between posaconazole levels and IFI risk was demonstrated in this study.
  • Further research is recommended to establish optimal therapeutic drug monitoring strategies.

Conclusions:

  • Posaconazole prophylaxis appears beneficial in reducing IFIs in acute leukaemia patients undergoing specific treatments.
  • Therapeutic drug monitoring of posaconazole is suggested for optimizing patient care.
  • The study highlights the importance of managing IFIs in immunocompromised leukaemia patients.
Keywords:
acute myeloid leukaemiainvasive fungal infectionsmyelodysplastic syndromesposaconazolevenetoclax

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