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Published in: Current Fungal Infection Reports 3/2013

01-09-2013 | Invited Commentary

Report From the 39th Annual Meeting of the European Group for Blood and Marrow Transplantation, London, 7–10 April 2013

Author: Sue Lyon

Published in: Current Fungal Infection Reports | Issue 3/2013

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Abstract

Antifungal prophylaxis reduces the risks of invasive fungal infection (IFI), all-cause mortality and fungal-related mortality in highly immunosuppressed haemato-oncology patients, but questions remain about the role of therapeutic drug monitoring in this patient population. There is also continuing debate concerning the benefits and risks of empirical versus pre-emptive antifungal therapy when breakthrough IFI occurs during prophylaxis. These topics were discussed during the 39th Annual Meeting of the European Group for Blood and Marrow Transplantation, held in London in April 2013.
Literature
1.
go back to reference Robenshtok E, Gafter-Gvili A, Goldberg E, et al. Antifungal prophylaxis in cancer patients after chemotherapy or hematopoietic stem-cell transplantation: systematic review and meta-analysis. J Clin Oncol. 2007;25:5471–89.PubMedCrossRef Robenshtok E, Gafter-Gvili A, Goldberg E, et al. Antifungal prophylaxis in cancer patients after chemotherapy or hematopoietic stem-cell transplantation: systematic review and meta-analysis. J Clin Oncol. 2007;25:5471–89.PubMedCrossRef
2.
go back to reference De Pauw B, Walsh TJ, Donnelly JP, et al. Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group. Clin Infect Dis. 2008;46:1813–21.PubMedCrossRef De Pauw B, Walsh TJ, Donnelly JP, et al. Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group. Clin Infect Dis. 2008;46:1813–21.PubMedCrossRef
4.
go back to reference Sanchez-Ortega I, Cuesta I, Patino B, et al. Clinical efficacy and management of primary antifungal prophylaxis with posaconazole in high-risk haematology patients. 39th Annual Meeting of the European Group for Blood and Marrow Transplantation, London 2013. Sanchez-Ortega I, Cuesta I, Patino B, et al. Clinical efficacy and management of primary antifungal prophylaxis with posaconazole in high-risk haematology patients. 39th Annual Meeting of the European Group for Blood and Marrow Transplantation, London 2013.
5.
go back to reference Cornely OA, Maertens J, Winston DJ, et al. Posaconazole vs fluconazole or itraconazole prophylaxis in patients with neutropenia. N Engl J Med. 2007;356:348–59.PubMedCrossRef Cornely OA, Maertens J, Winston DJ, et al. Posaconazole vs fluconazole or itraconazole prophylaxis in patients with neutropenia. N Engl J Med. 2007;356:348–59.PubMedCrossRef
6.
go back to reference Ullman AJ, Lipton JH, Vesole DH, et al. Posaconazole or fluconazole for prohylaxis in severe graft versus host disease. N Engl J Med. 2007;356:355–47. Ullman AJ, Lipton JH, Vesole DH, et al. Posaconazole or fluconazole for prohylaxis in severe graft versus host disease. N Engl J Med. 2007;356:355–47.
7.
go back to reference Marks DI, Pagliuca A, Kibbler CC, et al. Voriconazole versus itraconazole for antifungal prophylaxis following allogeneic haematopoietic stem-cell transplantation. Br J Haematol. 2011;155:318–27.PubMedCrossRef Marks DI, Pagliuca A, Kibbler CC, et al. Voriconazole versus itraconazole for antifungal prophylaxis following allogeneic haematopoietic stem-cell transplantation. Br J Haematol. 2011;155:318–27.PubMedCrossRef
8.
go back to reference Wingard JR, Carter SL, Walsh TJ, et al. Randomized, double-blind trial of fluconazole versus voriconazole for prevention of invasive fungal infection after allogeneic hematopoietic cell transplantation. Blood. 2010;116:5111–8.PubMedCrossRef Wingard JR, Carter SL, Walsh TJ, et al. Randomized, double-blind trial of fluconazole versus voriconazole for prevention of invasive fungal infection after allogeneic hematopoietic cell transplantation. Blood. 2010;116:5111–8.PubMedCrossRef
9.
go back to reference Trifilio S, Pennick G, Pi J, et al. Monitoring plasma voriconazole levels may be necessary to avoid subtherapeutic levels in hematopoietic stem cell transplant recipients. Cancer. 2007;109:1532–5.PubMedCrossRef Trifilio S, Pennick G, Pi J, et al. Monitoring plasma voriconazole levels may be necessary to avoid subtherapeutic levels in hematopoietic stem cell transplant recipients. Cancer. 2007;109:1532–5.PubMedCrossRef
10.
go back to reference Mitsani D, Nguyen MH, Shields RK, et al. Prospective, observational study of voriconazole therapeutic drug monitoring among lung transplant recipients receiving prophylaxis: factors impacting levels of and associations between serum troughs, efficacy, and toxicity. Antimicrob Agents Chemother. 2012;56:2371–7.PubMedCrossRef Mitsani D, Nguyen MH, Shields RK, et al. Prospective, observational study of voriconazole therapeutic drug monitoring among lung transplant recipients receiving prophylaxis: factors impacting levels of and associations between serum troughs, efficacy, and toxicity. Antimicrob Agents Chemother. 2012;56:2371–7.PubMedCrossRef
11.
go back to reference Walsh TJ, Raad I, Patterson TF, et al. Treatment of invasive aspergillosis with posaconazole in patients who are refractory to or intolerant of conventional therapy: an externally controled trial. Clin Infect Dis. 2007;44:2–12.PubMedCrossRef Walsh TJ, Raad I, Patterson TF, et al. Treatment of invasive aspergillosis with posaconazole in patients who are refractory to or intolerant of conventional therapy: an externally controled trial. Clin Infect Dis. 2007;44:2–12.PubMedCrossRef
12.
go back to reference Cornely OA, Ullmann AJ. Lack of evidence for exposure-response relationship in the use of posaconazole as prophylaxis against invasive fungal infections. Clin Pharmacol Ther. 2011;89:351–2.PubMedCrossRef Cornely OA, Ullmann AJ. Lack of evidence for exposure-response relationship in the use of posaconazole as prophylaxis against invasive fungal infections. Clin Pharmacol Ther. 2011;89:351–2.PubMedCrossRef
13.
go back to reference Cornely OA, Helfgott D, Langston A, et al. Pharmacokinetics of different dosing strategies of oral posaconazole in patients with compromised gastrointestinal function and who are at high risk for invasive fungal infection. Antimicrob Agents Chemother. 2012;56:2652–8.PubMedCrossRef Cornely OA, Helfgott D, Langston A, et al. Pharmacokinetics of different dosing strategies of oral posaconazole in patients with compromised gastrointestinal function and who are at high risk for invasive fungal infection. Antimicrob Agents Chemother. 2012;56:2652–8.PubMedCrossRef
14.
go back to reference Campoli P, Al Abdallah Q, Robitaille R, et al. Concentration of antifungal agents within host cell membranes: a new paradigm governing the efficacy of prophylaxis. Antimicrob Agents Chemother. 2011;55:5732–9.PubMedCrossRef Campoli P, Al Abdallah Q, Robitaille R, et al. Concentration of antifungal agents within host cell membranes: a new paradigm governing the efficacy of prophylaxis. Antimicrob Agents Chemother. 2011;55:5732–9.PubMedCrossRef
15.
go back to reference Campoli P, Attias O, Kristof AS, Perlin D, Sheppard DC. Posaconazole concentrates within the endoplasmic reticulum of host and fungal cells. 22nd European Congress of Clinical Microbiology and Infectious Diseases. London 2013. Campoli P, Attias O, Kristof AS, Perlin D, Sheppard DC. Posaconazole concentrates within the endoplasmic reticulum of host and fungal cells. 22nd European Congress of Clinical Microbiology and Infectious Diseases. London 2013.
16.
go back to reference Rieger CT, Huppmann S, Peterson L, Rieger H, Ostermann H. Classification of invasive fungal disease in patients with acute myeloid leukaemia. Mycoses. 2011;54:e92–8.PubMedCrossRef Rieger CT, Huppmann S, Peterson L, Rieger H, Ostermann H. Classification of invasive fungal disease in patients with acute myeloid leukaemia. Mycoses. 2011;54:e92–8.PubMedCrossRef
17.
go back to reference Rieger CT, Ostermann H. Empiric vs. preemptive antifungal treatment: an appraisal of treatment strategies in haematological patients. Mycoses. 2008;51 suppl 1:31–4.PubMedCrossRef Rieger CT, Ostermann H. Empiric vs. preemptive antifungal treatment: an appraisal of treatment strategies in haematological patients. Mycoses. 2008;51 suppl 1:31–4.PubMedCrossRef
18.
go back to reference Kontoyiannis DP, Marr KA, Park BJ, et al. Prospective surveillance for invasive fungal infections in hematopoietic stem cell transplant recipients, 2001–2006: overview of the Transplant-Associated Infection Surveillance Network (TRANSNET) Database. Clin Infect Dis. 2010;50:1091–100.PubMedCrossRef Kontoyiannis DP, Marr KA, Park BJ, et al. Prospective surveillance for invasive fungal infections in hematopoietic stem cell transplant recipients, 2001–2006: overview of the Transplant-Associated Infection Surveillance Network (TRANSNET) Database. Clin Infect Dis. 2010;50:1091–100.PubMedCrossRef
19.
go back to reference Pizzo PA, Robichaud KJ, Gill F, Witebsky F. Empiric antibiotic and antifungal therapy for cancer patients with prlonged fever and granulocytopenia. Am J Med. 1982;72:1010–111.CrossRef Pizzo PA, Robichaud KJ, Gill F, Witebsky F. Empiric antibiotic and antifungal therapy for cancer patients with prlonged fever and granulocytopenia. Am J Med. 1982;72:1010–111.CrossRef
20.
go back to reference EORTC International Antimicrobial Therapy Cooperative Group. Empriric antifungal therapy in febrile graulocytopenic patients. Am J Med. 1989;86(Pt1):668–72. EORTC International Antimicrobial Therapy Cooperative Group. Empriric antifungal therapy in febrile graulocytopenic patients. Am J Med. 1989;86(Pt1):668–72.
21.
go back to reference Walsh TJ, Finberg RW, Arndt C, et al. Lipsomal amphotericin B for empircal tgherapy in patients with persistent fever and neutropenia. N Engl J Med. 1999;340:1837–8.CrossRef Walsh TJ, Finberg RW, Arndt C, et al. Lipsomal amphotericin B for empircal tgherapy in patients with persistent fever and neutropenia. N Engl J Med. 1999;340:1837–8.CrossRef
22.
go back to reference Walsh TJ, Pappas P, Winston DJ, et al. Voriconazole compared with liposomal amphotericin B for empirical antifungal therapy in patients with neutropenia and persistent fever. N Engl J Med. 2002;351:1391–402.CrossRef Walsh TJ, Pappas P, Winston DJ, et al. Voriconazole compared with liposomal amphotericin B for empirical antifungal therapy in patients with neutropenia and persistent fever. N Engl J Med. 2002;351:1391–402.CrossRef
23.
go back to reference Walsh TJ, Teppler H, Donowitz GR, et al. Caspofungin versus liposomal amphotericin B for empirical antifungal therapy in patients with persistent fever and neutropenia. N Engl J Med. 2004;351. Walsh TJ, Teppler H, Donowitz GR, et al. Caspofungin versus liposomal amphotericin B for empirical antifungal therapy in patients with persistent fever and neutropenia. N Engl J Med. 2004;351.
24.
go back to reference Cordonnier C, Pautas C, Maury S, et al. Empirical versus preemptive antifungal therapy for high-risk, febrile, neutropenic patients: a randomized, controlled trial. Clin Infect Dis. 2009;48:1042–51.PubMedCrossRef Cordonnier C, Pautas C, Maury S, et al. Empirical versus preemptive antifungal therapy for high-risk, febrile, neutropenic patients: a randomized, controlled trial. Clin Infect Dis. 2009;48:1042–51.PubMedCrossRef
25.
go back to reference Teo C, Wong ZX, Poon MLM, Tan B. Comparative analysis of fluconazole versus posaconazole as antifungal prophylaxis in allogeneic haematopeoietic cell transplant patients. 39th Annual Meeting of the European Group for Blood and Marrow Transplantation, London 2013. Teo C, Wong ZX, Poon MLM, Tan B. Comparative analysis of fluconazole versus posaconazole as antifungal prophylaxis in allogeneic haematopeoietic cell transplant patients. 39th Annual Meeting of the European Group for Blood and Marrow Transplantation, London 2013.
26.
go back to reference Glass B, Bastubbe V, Dingeldein S, Nickelsen M, Zeis M, Schmitz N. Results of antimycotic prophylaxis with posaconazole in patients with severe graft-versus-host disease (GVHD): a single centre analysis. 39th Annual Meeting of the European Group for Blood and Marrow Transplantation, London 2013. Glass B, Bastubbe V, Dingeldein S, Nickelsen M, Zeis M, Schmitz N. Results of antimycotic prophylaxis with posaconazole in patients with severe graft-versus-host disease (GVHD): a single centre analysis. 39th Annual Meeting of the European Group for Blood and Marrow Transplantation, London 2013.
Metadata
Title
Report From the 39th Annual Meeting of the European Group for Blood and Marrow Transplantation, London, 7–10 April 2013
Author
Sue Lyon
Publication date
01-09-2013
Publisher
Springer US
Published in
Current Fungal Infection Reports / Issue 3/2013
Print ISSN: 1936-3761
Electronic ISSN: 1936-377X
DOI
https://doi.org/10.1007/s12281-013-0147-9

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