Clinical Efficacy and Safety of the Prophylactic Treatment of Fluconazole for Acute Aplastic Anemia Patients with Invasive Fungal Disease

OBJECTIVE To investigate the clinical efficacy and safety of the prophylactic treatment of fluconazole for acute aplastic anemia(AA) patients with invasive fungal disease(IFD) . METHODS Retrospectively analyzed 42 cases of the in-patients of acute aplastic anemia from September 2010 to October 2012 in the hematology department of Zhejiang Traditional Chinese Medicine Hospital, including 20 cases with the use of prophylactic treatment of fluconazole for IFD and left 22 cases without any drugs as a preventive treatment for IFD. Collected the general information of patients, blood routine, CD4T/CD8T cells, cytokines, liver and kidney function, recovery time of neutropenia, IFD occurrence and so on. RESULTS Before and after the fluconazole preventive treatment for IFD, observed the change of the percentage of CD4+/CD8+ group, and found that CD4+, CD8+ T cells were improved significantly, and the TNF-a and IL-2 levels were significantly decreased(P<0.05). But no significant difference was found in the cases without any prophylactic treatment, the level of T cells or the cytokines were improved after the treatment of AA. Compared the two groups, found that the granulocyte recovery(42 d) average time of the former was significantly shorter than the latter(76 d). CONCLUSION We are able to determine the use of fluconazole as antifungal prophylaxis strategies for reducing the incidence of deep fungal infections. During the treatment, no fluconazole injection-related adverse events were found. We recommend fluconazole as a priority prophylactic medication.