ISSN: 1300-7777 E-ISSN: 1308-5263
Antifungal prophylaxis in stem cell transplantation centers in Turkey [Turk J Hematol]
Turk J Hematol. 2011; 28(4): 271-275 | DOI: 10.5152/tjh.2011.81  

Antifungal prophylaxis in stem cell transplantation centers in Turkey

Hamdi Akan
Department Of Hematology, Faculty Of Medicine, Ankara University, Ankara, Turkey

OBJECTIVE: This study aimed to determine the current state of antifungal prophylaxis in Turkish stem cell transplantation (SCT) centers.
METHODS: he were 38 active stem cell transplantation centers in Turkey, 28 of which were registered with the European Group for Blood and Marrow Transplantation (EBMT). Survey questionnaires were sent to the 28 EBMT centers in an effort to collect data on antifungal prophylaxis in different settings. In all, 24 of the centers completed the survey; 1 of the 24 centers was excluded from the study, as it was under construction at the time and was not performing transplantation.
RESULTS: In all, 15 (65%) of the 23 centers were adult SCT centers, 7 (31%) were pediatric SCT centers, and 1 center treated both adult and pediatric patients. All centers (23/23) performed both allogeneic and autologous transplants, 20 centers performed non-myeloablative transplants, 8 performed cord blood transplants, and 7 performed unrelated transplants. Primary antifungal prophylaxis was used at all 23 centers during allogeneic transplants, whereas 18 of the 23 centers used it during every autologous transplant and 2 of the 23 centers used it during autologous transplants on a per case basis. The most common drug used for prophylaxis was fluconazole (F) (21/23), followed by itraconazole (I) (3/23), amphotericin-B (2/23), and posaconazole (1/23). Among the 23 centers, 3 reported that for allogenic transplants they changed the antifungal prophylactic in cases of graft versus host disease (GVHD), and 12 of the 23 centers reported that they changed the antifungal prophylactic in case of nearby construction. All 23 centers performed secondary prophylaxis.
CONCLUSION: Antifungal prophylaxis for hematopoetic SCT patients was the standard protocol in the 23 centers included in the study, usually with such azoles as F. The introduction of posaconazole in Turkey and the potential approval of voriconazole for antifungal prophylaxis will eventually alter prophylaxis practice in Turkey, which we plan to assess in the future.

Keywords: Prophylaxis, antifungal, stem cell transplantation


Türkiye'deki kök hücre nakli merkezlerinde antifungal profilaksi

Hamdi Akan
Department Of Hematology, Faculty Of Medicine, Ankara University, Ankara, Turkey

AMAÇ: Türkiye’deki kök hücre nakli merkezlerinde antifungal profilaksi eğilimlerini anlamak için yapılan bu çalışma bir anket çalışmasıdır.
YÖNTEMLER: Türkiye’de çalışan 38 kök hücre nakli merkezinden EBMT’ye kayıtlı 28 merkeze anket gönderilmiş ve 24 merkezden yanıt alınmıştır. Bir merkez halen inşaat yapımı nedeni ile anketi dolduramamıştır.
BULGULAR: Bu merkezlerden 15 tanesi erişkin (%65), 7 tanesi çocuk (%31) ve 1 tanesi erişkin ve çocuk nakil merkezidir. Tüm merkezler hem allogeneik, hem de otolog nakil yapmakta olup; 20 merkezde nonmyeloablatif, 8 merkezde kordon kanı ve 7 merkezde akraba dışı nakil yapılmaktadır. Tüm merkezlerde allogeneik nakillerde profilaksi yapılırken, 18/23 merkezde otolog nakillerde profilaksi yapılmaktadır. 23 merkezden 2'si ise, otolog nakilde olguya göre profilaksi vermektedir. En çok kullanılan ajan Flukonazol olup (21/23), bunu Itrakonazol (3/23), amfoterisin-B (2/23), ve posakonazol (1/23) izlemektedir. Allogeneik nakil yapılan 3 merkez Graft versus Host Hastalığı varlığında profilaksiyi değiştirmekte ve 12/23 merkez yakında inşaat olması durumunda profilaktik yaklaşımlarını değiştirmektedir. Tüm merkezler sekonder profilaksi yapmaktadır.
SONUÇ: Son yıllardaki gelişmeler bu alandaki yaklaşımları değiştirecek ve Flukonazol yerine yeni triazollerin geçmesine yol açacak niteliktedir. Bu nedenle bu anket 2013 yılında yinelenerek değişim olup olmadığı anlaşılacaktır.

Anahtar Kelimeler: Profilaksi, antifungal, kök hücre nakli


Hamdi Akan. Antifungal prophylaxis in stem cell transplantation centers in Turkey. Turk J Hematol. 2011; 28(4): 271-275

Corresponding Author: Hamdi Akan, Türkiye


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Impact Factor (2016) = 0.686