Evidence map›Paper›PMID 25371690›Full record

ArticleThe Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale2014

Serum voriconazole level variability in patients with hematological malignancies receiving voriconazole therapy.

Lalit Saini, Jack T Seki, Deepali Kumar, Eshetu G Atenafu, David Ec Cole, Betty Yl Wong, Andrea Božović, Joseph M Brandwein

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
1.1field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.

  1. Pooled it
  2. Evaluation of voriconazole therapeutic drug monitoring in malignant hematology patients.Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners · 2025
    Article
  3. Article
  4. Article
  5. Article
  6. Article
  7. Review
  8. Voriconazole and the liver.World journal of hepatology · 2015
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 2 countries.

Lalit SainiDivision of Hematology, Department of Medicine, University of Alberta, Edmonton, Alberta;
Jack T SekiDepartment of Pharmacy, Princess Margaret Cancer Centre; ; Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario;
Deepali KumarTransplant Infectious Diseases, Alberta Transplant Institute; ; University of Alberta, Edmonton, Alberta;
Eshetu G AtenafuBiostatistics Department, Princess Margaret Cancer Centre;
David Ec ColeDepartment of Laboratory Medicine and Pathophysiology and Department of Clinical Pathology, University of Toronto; ; Department of Clinical Pathology, Sunnybrook Health Sciences Centre;
Betty Yl WongDepartment of Clinical Pathology, Sunnybrook Health Sciences Centre;
Andrea BožovićLaboratory Medicine Program, Toronto General Hospital, University Health Network; ; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario.
Joseph M BrandweinDivision of Hematology, Department of Medicine, University of Alberta, Edmonton, Alberta;
University of Alberta · CASunnybrook Health Science Centre · CAUniversity of Toronto · CAPrincess Margaret Cancer Centre · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionVoriconazole plasma concentrations have been correlated with oral dosing in healthy subjects, but have been poorly characterized in ill patients with hematological malignancies receiving intensive chemotherapy.

methodsThe relationship between orally administered voriconazole, plasma concentrations and liver toxicity was examined in a cohort of 69 primarily acute leukemia patients undergoing intensive chemotherapy.

resultsOral administration of voriconazole was associated with significant interpatient variability, with voriconazole steady-state concentrations ranging from 0 μg/mL to 16.6 μg/mL. Approximately 20% of patients achieved steady-state concentrations <1 μg/mL. When adjusted for weight, patients receiving higher voriconazole doses tended toward higher plasma concentrations; however, there was no significant relationship between the plasma concentration and genotype, age, sex or use of concomitant proton pump inhibitors. Voriconazole concentrations were correlated with higher serum alkaline phosphatase levels at day 6 to 8, and with higher bilirubin and aspartate aminotransferase levels at day 14 to 16, but not with other liver enzyme levels.

conclusionIn ill patients with acute leukemia and related disorders undergoing treatment with oral voriconazole, there is a poor correlation between the voriconazole dose and plasma concentrations, and many patients achieve levels that are considered to be subtherapeutic. The findings support the routine use of therapeutic drug monitoring in these patients.

Indexed as

AntifungalsDrug levelsLiver toxicityVoriconazole

Identifiers

PMID25371690
PMCPMC4211351
OpenAlexW2258984734

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.