Recommendations on the use of azole antifungals in hematology-oncology patients

The administration of antifungals for therapeutic and, especially, prophylactic purposes is virtually a constant in patients requiring hematology-oncology treatment. Any attempt to prevent or treat Aspergillus or Mucor infections requires the administration of some drugs in the azole group, which in...

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Veröffentlicht in:Revista española de quimioterapia 2023-06, Vol.36 (3), p.236-258
Hauptverfasser: Azanza, J R, Mensa, J, Barberán, J, Vázquez, L, Pérez de Oteyza, J, Kwon, M, Yáñez, L, Aguado, J M, Cubillo Gracian, A, Solano, C, Ruiz Camps, I, Fortún, J, Salavert Lletí, M, Gudiol, C, Olave Rubio, T, García-Vidal, C, Rovira Tarrats, M, Suárez-Lledó Grande, M, González-Sierra, P, Dueñas Gutiérrez, C
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Sprache:eng
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Zusammenfassung:The administration of antifungals for therapeutic and, especially, prophylactic purposes is virtually a constant in patients requiring hematology-oncology treatment. Any attempt to prevent or treat Aspergillus or Mucor infections requires the administration of some drugs in the azole group, which include voriconazole, posaconazole and isavuconazole, noted for their activity against these pathogens. One very relevant aspect is the potential risk of interaction when associated with one of the antineoplastic drugs used to treat hematologic tumors, with serious complications. In this regard, acalabrutinib, bortezomib, bosutinib, carfilzomib, cyclophosphamide, cyclosporine A, dasatinib, duvelisib, gilteritinib, glasdegib, ibrutinib, imatinib, nilotinib, ponatinib, prednisone, ruxolitinib, tacrolimus, all-transretinoic acid, arsenic trioxide, venetoclax, or any of the vinca alkaloids, are very clear examples of risk, in some cases because their clearance is reduced and in others because of increased risk of QTc prolongation, which is particularly evident when the drug of choice is voriconazole or posaconazole.
ISSN:0214-3429
1988-9518
DOI:10.37201/req/013.2023