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Detection of Invasive Pulmonary Aspergillosis in Haematological Malignancy Patients by using Lateral-flow Technology
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Detection of Invasive Pulmonary Aspergillosis in Haematological Malignancy Patients by using Lateral-flow Technology

Published on: March 22, 2012

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Prophylaxis for aspergillosis in patients with haematological malignancies: pros and cons

Alessandro Busca1, Livio Pagano2

  • 1a Stem Cell Transplant Center , AOU Citta' della Salute e Della Scienza , Turin , Italy.

Expert Review of Anti-Infective Therapy
|July 24, 2018
PubMed
Abstract

Insights

Primary antifungal prophylaxis (PAP) is crucial for preventing invasive fungal infections (IFI) in high-risk hematologic patients. However, careful consideration of resistance, adverse events, and costs is essential when implementing PAP strategies.

Area of Science:

  • Hematology
  • Infectious Diseases
  • Pharmacology

Background:

  • Invasive fungal infections (IFI) pose a significant threat to patients with hematologic malignancies, impacting treatment outcomes.
  • Novel antifungal agents offer expanded activity but raise concerns about resistance, adverse events, and cost.
  • Primary antifungal prophylaxis (PAP) is a key strategy for IFI prevention in this vulnerable population.

Purpose of the Study:

  • To analyze the advantages and disadvantages of primary antifungal prophylaxis (PAP) in hematologic patients.
  • To evaluate the role of PAP in managing IFI in patients with hematologic malignancies.

Main Methods:

  • Review of current literature on antifungal prophylaxis in hematologic patients.
  • Analysis of the benefits and drawbacks of PAP, including efficacy, safety, and economic factors.
  • Consideration of factors influencing PAP decision-making, such as local epidemiology and diagnostic availability.

Main Results:

  • Patients undergoing intensive chemotherapy for acute myeloid leukemia/myelodysplastic syndromes (AML/MDS) and those receiving stem cell transplantation are at high risk for IFI and may benefit from PAP.
  • PAP implementation requires careful evaluation of local resistance patterns, potential adverse events, and healthcare costs.
  • Emerging targeted therapies may alter risk profiles, necessitating ongoing assessment of IFI risk categories.

Conclusions:

  • PAP is a critical component of IFI management in high-risk hematologic patients, but its use must be individualized.
  • Balancing the benefits of PAP against risks of resistance, adverse events, and cost is essential for optimal patient care.
  • Continuous monitoring of epidemiological trends and the impact of new therapies is necessary to refine IFI prevention strategies.
Keywords:
Antifungal prophylaxisdrug-drug interactionsechinocandinsmold-active agentspolyenes

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