Voriconazole (VRCZ) Versus Itraconazole (ITCZ) As Antifungal Prophylaxis For Acute Myelogenus Leukemia (AML) and Acute Lymphoblastic Leukemia (ALL) Patients In Induction Therapy, Prospective Randomized Study

There is little evidence to support the efficacy of dosage exceeding conventional high dose chemotherapy (HDC), referred to as super-HDC (SHDC) for Acute Leukemia (AL). However our hospital has been successfully conducting an original SHDC and has realized the highest complete remission rate and 10 years event free survival ratio for all generations with no selection bias. For example, de novo AML except M3 results are 91%, 59% for under 70 years old and 75%, 32% for over 70 years old respectively (51stASH #1052, until 2010). The treatment of complications is the key to SHDC success, with fungal infection one of the major complications. With our unique preemptive approach, we have successfully eliminated fungal mortalities on all AML patients with no selection bias (53stASH #1544). In this group using ITCZ as prophylaxis, pulmonary invasive aspergillosis (PIA) morbidity rate was still high, so we had to switch from ITCZ to VRCZ. Thus we theorized that VRCZ is more effective as prophylaxis. As there is little supporting data, we scheduled this prospective randomized study commencing 2011/4/23. This is the interim analysis of the first 100 of 200 patients as of 2012/9/26.