Consensus guidelines for antifungal prophylaxis in haematological malignancy and haemopoietic stem cell...

Area of Science:

• Medical Mycology
• Infectious Diseases
• Hematology/Oncology

Background:

• Invasive fungal disease (IFD) poses significant risks, with morbidity and mortality impacting vulnerable patient populations.
• Advances in malignancy treatment have identified new patient groups at increased risk for IFD.
• Evolving IFD epidemiology and the emergence of antifungal drug resistance necessitate updated prophylactic strategies.

Purpose of the Study:

• To review evidence and limitations of new antifungal prophylaxis formulations and agents.
• To provide recommendations for the optimal use and selection of antifungal prophylaxis.
• To highlight emerging risk groups and address the impact of changing IFD epidemiology and drug resistance.

Main Methods:

• Review of current evidence on antifungal prophylaxis in high-risk patients.
• Analysis of emerging risk factors and patient populations, including those undergoing advanced cancer therapies.
• Evaluation of new antifungal drug formulations and their efficacy and safety profiles.

Main Results:

• Identification of new 'at-risk' groups for IFD due to advancements in cancer treatment.
• Assessment of the impact of changing IFD epidemiology and drug resistance on prophylaxis choices.
• Review of evidence supporting new and established antifungal agents and formulations.

Conclusions:

• Optimizing antifungal prophylaxis requires precise targeting of patients at highest risk.
• Active surveillance and understanding local epidemiology are crucial for effective IFD prevention.
• Future directions include improved risk stratification to enhance management of vulnerable patients.