Abstract: Objective In order to compare the efficacy and cost-effectiveness of micafungin and itraconazole in the treatment of multiple myeloma with invasive fungal disease.Methods We restrospectively analyzed the clinical data of 37 multiple myeloma patients with invasive fungal disease. Then we analyzed the efficacy of antifungal therapy, treatment time, costs, and the adverse reactions.Results Seventeen patients were treated with micafungin, and 20 patients were treated with itraconazole. The micafungin group had higher effective rate 76.46% (13/17) vs 70% (14/20),(P=0.42>0.05).In micafungin group,2 patients occurred gastrointestinal reaction. In itraconazole group, 3 patients occurred digestive discomfort reaction ,2 patients occurred hypokalemia and digestive discomfort reaction, 3 patients occurred drug-induced renal impairment, 1 patient's renal function recovered after the drug was stopped, other 2 patients turned up with acute renal damage. The micafungin group had a lower adverse reactions was 11.76% (2/17) vs 40% (8/20),(P<0.05).The C/Es were 263.73 and 289.11 in micafungin group, itraconazole group, respectively.Conclusions In the treatment of multiple myeloma with IFD, The effective rate of treatment between itraconazole and micafungin had no statistical difference but the adverse reactions had significant difference, the cost-effectiveness ratio of micafungin is lower than itraconazole.

Key words: multiple myeloma, invasive fungnal disease, micafungin, itraconazole, cost-effectiveness ratio