Efficacy and predictive factors of intravenous itraconazole empirical treatment for patients with hematological malignancies suspected of invasive fungal disease

To evaluate the efficacy and safety as well as the predictive factors for overall success of (intravenous) IV itraconazole empirical treatment for patients with hematological malignancy. Eighty-two possible or probable invasive fungal disease (IFD) patients with hematological malignancy were enrolled in this cohort study. Patients were treated with IV Itraconazole for empirical treatment. After completion of IV itraconazole, 42 (51.2%) patients achieved overall success. The numbers and rates of patients reached absence of breakthrough fungal infection, resolution of fever prior to recovery from neutropenia and survival for above 7 were 74 (90.2%), 58 (70.7%) and 82 (100%), respectively. Among all patients, 50 (61.0%) patients showed no premature discontinuation. Nausea and vomit was observed in 6 (7.3%) patients, and hypohepatia was found in 4 (4.9%) patients. While hyperpyrexia and shiver existed in only 2 (2.4%) patients. Univariate logistic regression was performed, and age (P = 0.002), ECOG performance status (P = 0.009) as well as duration of baseline fever (P = 0.008) were correlated with overall success. And the multivariate logistic regression was performed, the analysis showed that age (P = 0.028) and duration of baseline fever (P = 0.023) were the independent factors predicting the overall success. This study revealed that IV itraconazole empirical treatment is effective and safe for patients with hematological malignancies, and age as well as duration of baseline fever could be served as convincing independently predictive factors for overall success of IV itraconazole empirical treatment.