{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T03:21:09Z","timestamp":1792552869503,"version":"4.5.0"},"reference-count":35,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2023,10,4]],"date-time":"2023-10-04T00:00:00Z","timestamp":1696377600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Isavuconazole (ISA) is a newer antifungal used in patients with history of hematologic malignancies and hematopoietic transplant and cellular therapies (HM\/TCT). Although it has a more favorable side\u2010effect profile, breakthrough invasive fungal infections (bIFIs) while on ISA have been reported.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this single\u2010center retrospective study evaluating HM\/TCT patients who received prophylactic ISA for \u22657 days, we evaluated the incidence and potential risk factors for bIFIs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We evaluated 106 patients who received prophylactic ISA. The patients were predominantly male (60.4%) with median age of 65 (range: 21\u201391) years. Acute myeloid leukemia (48\/106, 45.3%) was the most common HM, with majority having relapsed and\/or refractory disease (43\/106, 40.6%) or receiving ongoing therapy (38\/106, 35.8%).<\/jats:p><jats:p>Nineteen patients (17.9%) developed bIFIs\u2013nine proven [<jats:italic>Fusarium<\/jats:italic> (3), <jats:italic>Candida<\/jats:italic> (2), <jats:italic>Mucorales<\/jats:italic> plus <jats:italic>Aspergillus<\/jats:italic> (2), <jats:italic>Mucorales<\/jats:italic> (1), <jats:italic>Colletotrichum<\/jats:italic> (1)], four probable invasive pulmonary <jats:italic>Aspergillus<\/jats:italic>, and six possible infections. Twelve patients were neutropenic for a median of 28 (8\u2013253) days prior to bIFI diagnosis. ISA levels checked within 7 days of bIFI diagnosis (median: 3.65\u00a0\u03bcg\/mL) were comparable to industry\u2010sponsored clinical trials.<\/jats:p><jats:p>All\u2010cause mortality among the bIFI cases was 47.4% (9\/19).We also noted clinically significant cytomegalovirus co\u2010infection in 5.3% (1\/19). On univariate analysis, there were no significant differences in baseline comorbidities and potential risk factors between the two groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>ISA prophylaxis was associated with a significant cumulative incidence of bIFIs. Despite the appealing side\u2010effect and drug\u2010interaction profile of ISA, clinicians must be vigilant about the potential risk for bIFIs.\n<jats:boxed-text content-type=\"graphic\" position=\"anchor\"><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/tid14162-gra-0001-m.png\"><jats:alt-text>image<\/jats:alt-text><\/jats:graphic><\/jats:boxed-text><\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.14162","type":"journal-article","created":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T19:28:49Z","timestamp":1696534129000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Breakthrough invasive fungal infections on isavuconazole prophylaxis in hematologic malignancy &amp; hematopoietic stem cell transplant patients"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5821-048X","authenticated-orcid":false,"given":"Akshay M.","family":"Khatri","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases Department of Medicine UnityPoint Health\u2013Des Moines  Des Moines USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4938-125X","authenticated-orcid":false,"given":"Yoichiro","family":"Natori","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Medicine University of Miami Miller School of Medicine  Miami USA"},{"name":"Miami Transplant Institute Jackson Health System  Miami USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2765-582X","authenticated-orcid":false,"given":"Anthony","family":"Anderson","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Sylvester Comprehensive Cancer Center  Miami USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6514-4206","authenticated-orcid":false,"given":"Ra'ed","family":"Jabr","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Infectious Diseases, Mayo Clinic Health System\u2013Eau Claire  Miami USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shreya A.","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Sylvester Comprehensive Cancer Center  Miami USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akina","family":"Natori","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology Department of Medicine University of Miami Miller School of Medicine  Miami USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Namrata S.","family":"Chandhok","sequence":"additional","affiliation":[{"name":"Division of Hematology Department of Medicine University of Miami Miller School of Medicine  Miami USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krishna","family":"Komanduri","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology Department of Medicine University of California San Francisco  San Francisco USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele I.","family":"Morris","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Medicine University of Miami Miller School of Medicine  Miami USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9584-5011","authenticated-orcid":false,"given":"Jose F.","family":"Camargo","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Department of Medicine University of Miami Miller School of Medicine  Miami 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