• Joon Seong Park, Dong Hwan Kim, Chul Won Choi, Seong Hyun Jeong, Jin-Hyuk Choi, Kihyun Kim, Seok Jin Kim, Chul Won Jung, Deok-Hwan Yang, and Jun Ho Jang.
• Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, Korea.
• Acta Haematol. 2010 Jan 1; 124 (2): 92-7.

BackgroundThis observational study was conducted to document the efficacy and safety of the use of micafungin (Mycamine) as an empirical antifungal agent in febrile neutropenic patients.MethodsMicafungin was administered for sustained fever (>38.4°C) on days 3-5 following the initiation of empirical antibiotic therapy. The overall success rate and side effects were evaluated.ResultsA total of 47 patients with acute myeloid leukemia, acute lymphoblastic leukemia, myelodysplastic syndrome and lymphoma were enrolled in the study. The overall success rate of micafungin was 61.7% (29/47). A total of 3 patients (6.4%) experienced grade 3/4 elevations in their aspartate aminotransferase levels, and 10 patients (21%) experienced grade 3/4 hyperbilirubinemia, 9 of which resolved. Four patients died of septic shock. Younger patients (<50 years) and patients with acute lymphoblastic leukemia exhibited a better response to micafungin than other patients. Patients that were less profoundly neutropenic (≥0.05 × 10(9)/l) also had a better response to micafungin, as did the patients who recovered from their fever or neutropenia.ConclusionMicafungin has an excellent efficacy (61.7%) and safety profile when used as an empirical antifungal agent in febrile neutropenic patients with hematological disorders.Copyright © 2010 S. Karger AG, Basel.

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