Characteristics and outcomes | Diagnostic-driven therapy with voriconazole | Empiric antifungal therapy without voriconazole | p-value |
---|---|---|---|
(n = 44) | (n = 221) | ||
N (%) | N (%) | ||
Age (years), median (range) | 63 (23–81) | 51 (14–80) | < 0.001 |
Gender, male | 26 (59) | 131 (59) | 0.98 |
Diagnosis of IA | Â | Â | < .001 |
 Definite IA | 4/43 (9) | 83 (38) |  |
 Probable IA | 39/43 (91) | 138 (62) |  |
Invasive pulmonary infectiona | 40 (91) | 178 (81) | 0.10 |
Disseminated infectiona | 2 (5) | 18 (8) | 0.41 |
Localized or sinus infectiona | 4 (9) | 28 (13) | 0.51 |
Leukemia | 19 (43) | 181/220 (82) | < .0001 |
Lymphoma | 16 (36) | 34/220 (15) | 0.001 |
Myeloma | 8 (18) | 5/220 (2) | < .001 |
Transplantation within 1 year prior to infection | 16 (36) | 82/220 (37) | 0.91 |
Type of transplantation within prior year | Â | Â | 0.010 |
 Allogeneic transplant | 10/16 (63) | 74/82 (90) |  |
 Autologous transplant | 6/16 (38) | 8/82 (10) |  |
Graft vs Host Disease (GVHD) | 8/10 (80) | 52/74 (70) | 0.72 |
Neutropenia (< 500 ANC) at onset of IA | 8/42 (19) | 120/216 (56) | < .0001 |
Persistent neutropenia | 14/36 (39) | 87/210 (41) | 0.77 |
Received immunotherapy | 10/43 (23) | 154/220 (70) | < .0001 |
Received WBC transfusion | 2/42 (5) | 45 (20) | 0.016 |
Year of IA diagnosis/treatment | Â | Â | < .0001 |
 1993–2004 | 8 (18) | 162 (73) |  |
 2005–2016 | 36 (82) | 59 (27) |  |
Prophylactic antifungal treatment prior to | 7 (16) | 78 (35) | 0.012 |
infection | Â | Â | Â |
Breakthrough | 6/7 (86) | 67/78 (86) | > .99 |
Response to therapy | 32 (73) | 30 (14) | < .0001 |
Death within 42 days of starting therapy | 2 (5) | 123/220 (56) | < .0001 |
Aspergillosis-attributable death within 42 days of starting therapy | 2 (5) | 107/218 (49) | < .0001 |