Pharmacokinetics of posaconazole prophylaxis of patients with acute myeloid leukemia

Gloria Mattiuzzi, Musa Yilmaz, Hagop Kantarjian, Gautam Borthakur, Marina Konopleva, Elias Jabbour, Yolanda Brown, Sherry Pierce, Jorge Cortes

Research output: Contribution to journalArticle

Abstract

Antifungal prophylaxis is routinely given to patients with hematologic malignancies at high risk for invasive fungal infections (IFI), yet breakthrough IFI may still occur. Posaconazole emerged as an excellent alternative for fungal prophylaxis in high-risk patients. There is limited data about pharmacokinetics and plasma concentrations of posaconazole when given as prophylaxis in patients with hematologic malignancies. We recruited 20 adult patients for prospective, open label trial of posaconazole given as a prophylaxis in patients with newly diagnosed acute myeloid leukemia (AML) undergoing induction chemotherapy or first salvage therapy. The median age of all patients was 65 years and received prophylaxis for a median of 38 days (range: 5-42 days).Ten patients (50%) completed 42 days on posaconazole prophylaxis. Median plasma posaconazole levels showed no statistical difference across gender, body surface area, patients developing IFI, and patients acquiring grade 3 or 4 elevation of liver enzymes. However, there was an overall trend for higher trough concentrations among patients with no IFI than those with IFI. Pharmacokinetics of posaconazole varies from patient to patient, and AML patients receiving induction chemotherapy who never develop IFI tend to have higher plasma concentrations after oral administration of posaconazole.

Original languageEnglish (US)
Pages (from-to)663-667
Number of pages5
JournalJournal of Infection and Chemotherapy
Volume21
Issue number9
DOIs
StatePublished - Sep 1 2015
Externally publishedYes

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Acute Myeloid Leukemia
Pharmacokinetics
Induction Chemotherapy
Hematologic Neoplasms
posaconazole
Salvage Therapy
Body Surface Area
Oral Administration
Invasive Fungal Infections

Keywords

  • Acute leukemia
  • Antifungal prophylaxis
  • Posaconazole

ASJC Scopus subject areas

  • Microbiology (medical)
  • Pharmacology (medical)
  • Infectious Diseases

Cite this

Pharmacokinetics of posaconazole prophylaxis of patients with acute myeloid leukemia. / Mattiuzzi, Gloria; Yilmaz, Musa; Kantarjian, Hagop; Borthakur, Gautam; Konopleva, Marina; Jabbour, Elias; Brown, Yolanda; Pierce, Sherry; Cortes, Jorge.

In: Journal of Infection and Chemotherapy, Vol. 21, No. 9, 01.09.2015, p. 663-667.

Research output: Contribution to journalArticle

Mattiuzzi, G, Yilmaz, M, Kantarjian, H, Borthakur, G, Konopleva, M, Jabbour, E, Brown, Y, Pierce, S & Cortes, J 2015, 'Pharmacokinetics of posaconazole prophylaxis of patients with acute myeloid leukemia', Journal of Infection and Chemotherapy, vol. 21, no. 9, pp. 663-667. https://doi.org/10.1016/j.jiac.2015.05.011
Mattiuzzi G, Yilmaz M, Kantarjian H, Borthakur G, Konopleva M, Jabbour E et al. Pharmacokinetics of posaconazole prophylaxis of patients with acute myeloid leukemia. Journal of Infection and Chemotherapy. 2015 Sep 1;21(9):663-667. https://doi.org/10.1016/j.jiac.2015.05.011
Mattiuzzi, Gloria ; Yilmaz, Musa ; Kantarjian, Hagop ; Borthakur, Gautam ; Konopleva, Marina ; Jabbour, Elias ; Brown, Yolanda ; Pierce, Sherry ; Cortes, Jorge. / Pharmacokinetics of posaconazole prophylaxis of patients with acute myeloid leukemia. In: Journal of Infection and Chemotherapy. 2015 ; Vol. 21, No. 9. pp. 663-667.
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