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Annals of Hematology
Published in: Annals of Hematology 2/2003

01-10-2003

Prophylaxis of invasive fungal infections in patients with hematological malignancies and solid tumors

Guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Oncology (DGHO)

Authors: Oliver A. Cornely, Angelika Böhme, Dieter Buchheidt, Axel Glasmacher, Christoph Kahl, Meinolf Karthaus, Winfried Kern, William Krüger, Georg Maschmeyer, Jörg Ritter, Hans J. Salwender, Michael Sandherr, Xaver Schiel, Silke Schüttrumpf, Michal Sieniawski, Gerda Silling, Andrew J. Ullmann, Hans-Heinrich Wolf

Published in: Annals of Hematology | Special Issue 2/2003

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Abstract

Morbidity and mortality in patients with malignancies, especially leukemia and lymphoma, are increased by invasive fungal infections. Since diagnosis of invasive fungal infection is often delayed, antifungal prophylaxis is an attractive approach for patients expecting prolonged neutropenia. Antifungal prophylaxis has obviously attracted much interest resulting in dozens of clinical trials since the late 1970s. The non-absorbable polyenes are probably ineffective in preventing invasive fungal infections, but may reduce superficial mycoses. Intravenous amphotericin B and the newer azoles were used in clinical trials, but their role in antifungal prophylaxis is still not well defined. Allogeneic stem cell transplant recipients are at particularly high risk for invasive fungal infections. Other well described risk factors are neutropenia >10 days, corticosteroid therapy, sustained immunosuppression, graft versus host disease, and concomitant viral infections. The enormous study efforts are contrasted by a scarcity of risk stratified evidence based recommendations for clinical decision making. The objective of this review accumulating information on about 10.000 patients is to assess evidence based criteria primarily regarding the efficacy of antifungal prophylaxis in neutropenic cancer patients.
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Metadata
Title
Prophylaxis of invasive fungal infections in patients with hematological malignancies and solid tumors
Guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Oncology (DGHO)
Authors
Oliver A. Cornely
Angelika Böhme
Dieter Buchheidt
Axel Glasmacher
Christoph Kahl
Meinolf Karthaus
Winfried Kern
William Krüger
Georg Maschmeyer
Jörg Ritter
Hans J. Salwender
Michael Sandherr
Xaver Schiel
Silke Schüttrumpf
Michal Sieniawski
Gerda Silling
Andrew J. Ullmann
Hans-Heinrich Wolf
Publication date
01-10-2003
Publisher
Springer-Verlag
Published in
Annals of Hematology / Issue Special Issue 2/2003
Print ISSN: 0939-5555
Electronic ISSN: 1432-0584
DOI
https://doi.org/10.1007/s00277-003-0773-3

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