Hematology patients are at high risk for invasive fungal infection (IFI) and are being
treated with voriconazole (VOR) at Princess Margaret Hospital (PMH). It is critical that
patients' serum drug levels are within therapeutic ranges when undergoing treatment. The
primary objective of this study is to determine whether clinical responses
(complete/partial/failure) directly correlate with patients' blood VOR drug levels.
In patients whose disease progression is associated with inadequate voriconazole (VOR) drug
levels, serum drug level determination can allow for dose adjustment, thereby preventing
disease progression. Patients who are extensive metabolizers may have subtherapeutic VOR
levels leading to treatment failure whereas, poor metabolizers may have high drug levels that
cause toxicity. Isoenzyme such as CYP2C19 exhibits genetic polymorphism. Genotyping tests can
also be helpful in determining patient risk subjecting to extreme spectrum of drug levels.