Objective: To explore the role of therapeutic drug monitoring of voriconazole in children with hematological disease. Methods: Clinical data of 62 children with hematological disease treated with voriconazole from Feb. 2019 to Aug. 2020 were collected. The trough concentration of voriconazole was determined by high performance liquid chromatography. According to the dose of voriconazole

the children were divided into 3 groups: less than 4.0 mg/kg group

from 4.0 to 6.0 mg/kg group

more than 6.0 mg/kg group. Clinical characteristics were compared. Results: The overall blood concentration compliance rate was 57.5%. The age

body weight and height of children in voriconazole dose more than 6.0 mg/kg group were significantly lower than those in other two groups. The combination of glucocorticoids decreased voriconazole concentration

while the combination of meropenem increased voriconazole concentration. The incidence of liver injury for voriconazole was 12.3%. There was no statistically significant difference of voriconazole concentration between the children with normal and abnormal liver function. Conclusion: The overall blood concentration compliance rate of voriconazole in children with hematological disease is relatively low. Young children are more likely to have low voriconazole concentration and need a larger body mass dose to reach the therapeutic concentration. Voriconazole concentration could be affect by drug combination in clinical practice

the therapeutic drug monitoring of voriconazole in children with hematological disease is beneficial to guide the individual medicine therapy.