Longitudinal changes in laboratory parameters and QTc during isavuconazole therapy in Japanese patients with hematologic malignancies

What the report says

PLOS One reported a retrospective study examining the safety of isavuconazole, an azole antifungal, in Japanese patients with hematologic malignancies. The paper, by Koichi Ohata and colleagues, was published July 29, 2026, and analyzed 45 consecutive patients treated at Gifu University Hospital’s Department of Hematology and Infectious Diseases between April 2023 and March 2025.

The researchers reviewed medical records for laboratory values and corrected QT interval measures, using longitudinal statistical models to track changes during therapy. They found grade 2 or higher increases in AST and ALT liver enzymes in 11.1% and 13.3% of patients, respectively, and described these changes as temporary. The study reported no meaningful worsening in the monitored laboratory parameters overall.

A key focus was patients receiving arsenic trioxide, a treatment used in some hematologic cancers that is associated with QT prolongation. In that subgroup, patients treated with both arsenic trioxide and isavuconazole had lower QTc values than those receiving arsenic trioxide alone from Day 30 onward, with the largest reported difference at Day 70. Patients receiving arsenic trioxide with other antifungals had trends more similar to arsenic trioxide alone. No clinically significant cardiac events were reported.

The findings matter because invasive fungal infections are a serious risk for patients undergoing intensive blood cancer treatment, while QT prolongation can complicate therapy choices. The authors concluded that isavuconazole showed a favorable safety profile and may be useful when QT-prolonging therapies are needed. The study was supported by joint research funding from Asahi Kasei Therapeutics Corporation, and the article lists several author financial disclosures.