[Invasive candidiasis after hematopoietic cell transplantation]

Candida species are the second most frequent fungal pathogen of invasive fungal disease after hematopoietic cell transplantation (HCT) following Aspergillus species. Prolonged severe neutropenia and mucocutaneous barrier impairment resulting from the conditioning regimen or central venous catheter placement are major risk factors for invasive candidiasis in the early phase after HCT. Graft-versus-host disease (GVHD) and corticosteroid use affect the development of invasive candidiasis in the post-engraftment phase after allogeneic HCT. Breakthrough candidemia mainly caused by non-albicans Candida species still occurs and is associated with a high mortality rate although antifungal prophylaxis that covers Candida species is a standard of care in HCT. A multidisciplinary approach is required to treat patients with candidiasis, involving multiple healthcare professionals from different fields, such as transplant physicians, infectious disease specialists, ophthalmologists, nurses, pharmacologists, and laboratory technicians. This review focuses on the epidemiology, risk factors, antifungal prophylaxis, diagnosis, and treatment of invasive candidiasis after HCT. Additionally, the association between Candida species and GVHD in allogeneic HCT is discussed.