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Evaluation of Antifungal Prophylaxis Strategy for Allogeneic Hematopoietic Cell Transplant Patients. Leah B. Herity, PharmD, MPH PGY1 Pharmacy Practice Resident Virginia Commonwealth University Health System. Disclosure.
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Evaluation of Antifungal Prophylaxis Strategy for Allogeneic Hematopoietic Cell Transplant Patients • Leah B. Herity, PharmD, MPH • PGY1 Pharmacy Practice Resident • Virginia Commonwealth University Health System
Disclosure • The authors and contributors of this project have no conflict of interest to disclose.
Invasive Mold Infections (IMI)in Allogeneic Hematopoietic Cell Transplant (HCT) Patients Clin Chest Med. 2017 Dec;38(4):727-73 TransplInfect Dis. 2018;e12897 Biol Blood Marrow Transplant. 2013;19(8):11906
Previous Studies of Antifungal Prophylaxis RCT = randomized, controlled trial
Primary Antifungal Prophylaxis Strategy at Virginia Commonwealth University (VCU) Health System • Patients may be switched to other antifungals depending on certain characteristics Post-engraftment Pre-engraftment
Objective • To determine the incidence and outcomes of IMI in allogeneic HCT patients at VCU Health System receiving primary antifungal prophylaxis
Methods • Retrospective medical record review • Data collected from Cerner Information Systems • January 1, 2013 through December 31, 2017 • Patients followed for 1 year post-transplant • Quality improvement project • VCU Institutional Review Board • Massey Cancer Center Protocol Review and Monitoring Committee (PRMC)
Endpoints *Death within 12 weeks of IMI diagnosis
Statistical Analysis • Demographics • Descriptive statistics • Primary outcome • Incidence rates • Kaplan-Meier survival estimates and log-rank tests • Secondary outcomes • Descriptive statistics • Chi-squared and Fisher’s Exact tests for risk factors • Analyses performed in Stata MP 15.1
Patient Characteristics No statistically significant differences between groups
Patient Characteristics *P<0.001 by chi-squared test
Proven or Probable IMI Incidence Rate 33 cases per 100 patient-years
Proven or Probable IMI by Underlying Disease P-value = 0.44
Proven or Probable IMI by Transplant Type P-value = 0.09
Overall Survival P-value < 0.0001
Acknowledgments • May T. Aziz, PharmD, BCPS, BCOP • Teresa Potter, PharmD, MPH, BCPS • Oveimar A. De la Cruz, M.D.
Questions? • Leah B. Herity, PharmD, MPH • leah.herity@vcuhealth.org • 804-828-6748