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Updated: Jun 9, 2026

Generation of Multivirus-specific T Cells to Prevent/treat Viral Infections after Allogeneic Hematopoietic Stem Cell Transplant
08:52

Generation of Multivirus-specific T Cells to Prevent/treat Viral Infections after Allogeneic Hematopoietic Stem Cell Transplant

Published on: May 27, 2011

Isavuconazole prophylaxis and treatment in pediatric HSCT recipients: Pharmacokinetics, safety, and efficacy

Hao Jiang1, Lixiao Cai2, Ningning Chen2

  • 1Department of Stem cell Transplantation, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.

International Journal of Antimicrobial Agents
|June 7, 2026
PubMed

Insights

Isavuconazole is safe and effective for preventing invasive fungal diseases in pediatric stem cell transplant patients. A trough concentration target of 1-3 mg/L is sufficient for prophylaxis, with TDM crucial for optimal dosing, especially in young children.

Area of Science:

  • Pharmacology
  • Hematology
  • Infectious Diseases

Background:

  • Pediatric hematopoietic stem cell transplantation (HSCT) recipients are at high risk for invasive fungal diseases (IFDs).
  • Isavuconazole is a newer azole antifungal agent with a broad spectrum of activity.
  • Optimal dosing and therapeutic drug monitoring (TDM) targets for isavuconazole in pediatric HSCT populations require further definition.

Purpose of the Study:

  • To evaluate the pharmacokinetics, safety, and efficacy of isavuconazole for IFD prophylaxis in pediatric HSCT recipients.
  • To define an optimal TDM trough concentration target for isavuconazole prophylaxis in this population.

Main Methods:

  • Retrospective analysis of 30 pediatric patients undergoing HSCT, receiving isavuconazole for prophylaxis (n=23) or salvage (n=7).
  • Evaluation of plasma trough concentrations (Cmin), concentration-to-dose ratios (C/D), breakthrough IFDs, and adverse events.
  • Specific focus on a target Cmin of 1-3 mg/L for prophylaxis.

Main Results:

  • A Cmin of 1-3 mg/L achieved 95.7% clinical success in the prophylaxis group.
  • The defined target range demonstrated a favorable safety profile without dose-limiting toxicities.
  • Children under 6 years showed significantly lower C/D ratios, indicating faster drug clearance and need for higher weight-based doses.

Conclusions:

  • Isavuconazole is effective and safe for IFD prophylaxis in pediatric HSCT recipients.
  • A Cmin target of 1-3 mg/L is adequate for prophylaxis, differing from treatment targets.
  • Routine TDM is essential for optimizing isavuconazole dosing, particularly in children under 6 years.
Abstract

Keywords:
Hematopoietic stem cell transplantationInvasive fungal diseasesIsavuconazolePediatric

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