Treatment of invasive aspergillosis in cancer patients

被引:0
作者
Auberger J. [1 ]
Russ G. [1 ]
Greil R. [1 ]
Egle A. [1 ]
机构
[1] IIIrd Med. Dept. with Hematol., Med. Oncology, Hemostaseology, Rheumatology and Infectious Diseases, Salzburg Private Medical University Hospital, 5020 Salzburg
关键词
Antifungal treatment; Aspergillus; Cancer; Fungal infections; Immunocompromised; Recommendations;
D O I
10.1007/s12254-011-0304-1
中图分类号
学科分类号
摘要
Invasive fungal infections (IFI) remain a leading cause of morbidity and mortality in immunocompromised patients. Despite major improvements, it often remains difficult to obtain accurate diagnosis in neutropenic patients. Timely initiation of antifungal treatment in this high-risk population is mandatory to improve survival. Today, clinicians have a choice among a growing armamentarium of novel antifungal agents. Agents such as "veteran" amphotericin B deoxycholate (d-AMB) have been replaced with lipid formulations, and new generation triazoles as well as novel class echinocandins finally offer opportunities to improve prognosis with less systemic toxicity. Clinical decision-making depends on several guidelines, published studies and not least on economic considerations. The current review summarises up-to-date treatment recommendations of the DGHO/AGIHO, and ECIL-3, as well as the recently published 2010 Clinical Practice Guidelines of the IDSA. © Springer-Verlag 2011.
引用
收藏
页码:266 / 272
页数:6
相关论文
共 75 条
  • [1] Pagano L., Current therapeutic approaches to fungal infections in immunocompromised hematological patients, Blood Reviews, 24, pp. 51-61, (2010)
  • [2] Auberger J., Lass-Florl C., Ulmer H., Et al., Significant alterations in the epidemiology and treatment outcome of invasive fungal infections in patients with hematological malignancies, Int J Haematol, 88, 5, pp. 508-515, (2008)
  • [3] Pagano L., Caira M., Candoni A., Et al., The epidemiology of fungal infections in patients with hematologic malignancies: The SEIFEM-2004 study, Haematologica, 91, pp. 1068-1075, (2006)
  • [4] Pagano L., Caira M., Nosari A., Et al., Fungal infections in recipients of hematopoietic stem cell transplantation: The SEIFEM B-2004 study, Clin Infect Dis, 45, pp. 1161-1170, (2007)
  • [5] Cornet M., Fleury L., Maslo C., Bernard J.F., Brucker G., Epidemiology of invasive aspergillosis in France: A six-year multicentric survey in the Greater Paris area, J Hosp Infect, 51, pp. 288-296, (2002)
  • [6] Hoenigl M., Zollner-Schwetz I., Sill H., Et al., Epidemiology of invasive fungal infections and rationale for antifungal therapy in patients with haematological malignancies, Mycoses, 54, 5, pp. 454-459, (2010)
  • [7] Perkhofer S., Lass-Florl C., Hell M., Et al., The nationwide Austrian Aspergillus Registry: A prospective data collection on epidemiology, therapy and outcome of invasive mould infections in immunocompromised and/or immunosuppressed patients, Int J of Antimicrobiol Agents, 36, 6, pp. 531-536, (2010)
  • [8] White P.L., Perry M.D., Barnes R.A., An update on the molecular diagnosis of invasive fungal infections, FEMS Microbiol Lett, 296, pp. 1-10, (2009)
  • [9] Lass-Florl C., Resch G., Nachbaur D., Et al., The value of computed tomography-guided percutaneous lung biopsies in diagnosing invasive fungal infections in immunocompromised patients, Clin Infect Dis, 45, (2007)
  • [10] Ascioglu S., Rex J.H., De Pauw B., Defining opportunistic invasive fungal infections in immunocompromised patients with cancer and hematopoietic stem cell transplants: A systematic review of the literature, Clin Infect Dis, 32, pp. 358-366, (2005)