PMID- 22568999
OWN - NLM
STAT- MEDLINE
DCOM- 20120720
LR  - 20220321
IS  - 1532-1827 (Electronic)
IS  - 0007-0920 (Print)
IS  - 0007-0920 (Linking)
VI  - 106
IP  - 10
DP  - 2012 May 8
TI  - Mould-active compared with fluconazole prophylaxis to prevent invasive fungal 
      diseases in cancer patients receiving chemotherapy or haematopoietic stem-cell 
      transplantation: a systematic review and meta-analysis of randomised controlled 
      trials.
PG  - 1626-37
LID - 10.1038/bjc.2012.147 [doi]
AB  - BACKGROUND: Objectives were to compare systemic mould-active vs fluconazole 
      prophylaxis in cancer patients receiving chemotherapy or haematopoietic stem cell 
      transplantation (HSCT). METHODS: We searched OVID MEDLINE and the Cochrane 
      Central Register of Controlled Trials (1948-August 2011) and EMBASE (1980-August 
      2011). Randomised controlled trials of mould-active vs fluconazole prophylaxis in 
      cancer or HSCT patients were included. Primary outcome was proven/probable 
      invasive fungal infections (IFI). Analysis was completed by computing relative 
      risks (RRs) using a random-effects model and Mantel-Haenszel method. RESULTS: 
      From 984 reviewed articles, 20 were included in this review. Mould-active 
      compared with fluconazole prophylaxis significantly reduced the number of 
      proven/probable IFI (RR 0.71, 95% CI 0.52 to 0.98; P=0.03). Mould-active 
      prophylaxis also decreased the risk of invasive aspergillosis (IA; RR 0.53, 95% 
      confidence interval (CI) 0.37-0.75; P=0.0004) and IFI-related mortality (RR 0.67, 
      95% CI 0.47-0.96; P=0.03) but is also associated with an increased risk of 
      adverse events (AEs) leading to antifungal discontinuation (RR 1.95, 95% CI 
      1.24-3.07; P=0.004). There was no decrease in overall mortality (RR 1.0; 95% CI 
      0.88-1.13; P=0.96). CONCLUSION: Mould-active compared with fluconazole 
      prophylaxis significantly reduces proven/probable IFI, IA, and IFI-related 
      mortality in cancer patients receiving chemotherapy or HSCT, but increases AE and 
      does not affect overall mortality. (PROSPERO Registration: CRD420111174).
FAU - Ethier, M C
AU  - Ethier MC
AD  - Program in Child Health Evaluative Sciences, The Hospital for Sick Children, 
      Toronto M5G 1X8, Ontario, Canada.
FAU - Science, M
AU  - Science M
FAU - Beyene, J
AU  - Beyene J
FAU - Briel, M
AU  - Briel M
FAU - Lehrnbecher, T
AU  - Lehrnbecher T
FAU - Sung, L
AU  - Sung L
LA  - eng
GR  - Canadian Institutes of Health Research/Canada
PT  - Comparative Study
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PT  - Systematic Review
PL  - England
TA  - Br J Cancer
JT  - British journal of cancer
JID - 0370635
RN  - 0 (Antifungal Agents)
RN  - 0 (Antineoplastic Agents)
RN  - 8VZV102JFY (Fluconazole)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Antifungal Agents/*therapeutic use
MH  - Antineoplastic Agents/*adverse effects
MH  - Child
MH  - Child, Preschool
MH  - Fluconazole/*therapeutic use
MH  - Hematopoietic Stem Cell Transplantation/*adverse effects
MH  - Humans
MH  - Infant
MH  - Middle Aged
MH  - Mycoses/*prevention & control
MH  - Neoplasms/*therapy
MH  - *Randomized Controlled Trials as Topic
PMC - PMC3349180
EDAT- 2012/05/10 06:00
MHDA- 2012/07/21 06:00
PMCR- 2013/05/08
CRDT- 2012/05/10 06:00
PHST- 2012/05/10 06:00 [entrez]
PHST- 2012/05/10 06:00 [pubmed]
PHST- 2012/07/21 06:00 [medline]
PHST- 2013/05/08 00:00 [pmc-release]
AID - bjc2012147 [pii]
AID - 10.1038/bjc.2012.147 [doi]
PST - ppublish
SO  - Br J Cancer. 2012 May 8;106(10):1626-37. doi: 10.1038/bjc.2012.147.