Efficacy of Combination Chemotherapy with Miconazole and G-CSF in Deep Mycosis Accompanying Hematological Diseases

In order to examine the efficacy of the combination chemotherapy with miconazole and G-CSF, patients with deep mycosis and suspected deep mycosis were divided into 3 groups. Group, I: miconazole and G-CSF were administered simultaneously. Group II: micronazole was administered later during G-CSF administration. Group III: only miconazole was administered. Of a total of 117 cases 105 cases were analyzed including group I 37 cases, group II 39 cases and group III 29 cases, excluding 12 dropout and inadequate cases. Of the 105 cases, deep mycosis were 31 and suspected deep mycosis were 74, and underlying diseases were hematological malignancies such as leukemias. Efficacy judged mainly by the change of fever was 62.2%(23/37) in group I, 43.6%(17/39) in group II, and 41.4%(12/29) in group III, respectively. Efficacy was better in the patients whose neutrophil counts increased from less than 500/μl to more than 500/μl (group I 75.0%, group II 72.7%) than in the patients whose neutrophil counts were less than 500/μl throughout the time of miconazole administration (group I 33.3%, group II 33.3%). Adverse effects were minimal in 3 gruops (group I 15.4%, group II 17.4%, group III 15.6%). It is concluded that the combination with miconazole and G-CSF is effective in the treatment of deep fungal infections.