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01.09.2014 | Review Article

Primary prophylaxis of invasive fungal infections in patients with haematologic malignancies. 2014 update of the recommendations of the Infectious Diseases Working Party of the German Society for Haematology and Oncology

verfasst von: Daniela Tacke, Dieter Buchheidt, Meinolf Karthaus, Stefan W. Krause, Georg Maschmeyer, Silke Neumann, Helmut Ostermann, Olaf Penack, Christina Rieger, Markus Ruhnke, Michael Sandherr, Katharina E. Schweer, Andrew J. Ullmann, Oliver A. Cornely

Erschienen in: Annals of Hematology | Ausgabe 9/2014

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Abstract

Invasive fungal infections cause substantial morbidity and mortality in immunocompromised patients, particularly in those with haematological malignancies and recipients of allogeneic haematopoietic stem cell transplantation. Difficulties in diagnosing invasive fungal infections and subsequent delays in treatment initiation lead to unfavourable outcomes and emphasise the importance of prophylaxis. Since the recommendations of the Infectious Diseases Working Party of the German Society for Haematology and Oncology in 2009, results of 14 additional clinical studies have been published comprising 2,899 patients and initiating this update. Key recommendations for adult patients are as follows: Posaconazole remains the drug of choice during remission-induction chemotherapy in acute myeloid leukaemia, myelodysplastic syndrome and allogeneic haematopoietic stem cell transplantation with graft versus host disease (AI). In the pre-engraftment period of allogeneic transplantation, several antifungals are appropriate and can be recommended with equal strength: voriconazole (BI), micafungin (BI), fluconazole (BI) and posaconazole (BII). There is poor evidence regarding antifungal prophylaxis in the post-engraftment period of allogeneic haematopoietic stem cell transplantation if no steroids for treatment of graft versus host disease are required. Aerosolised liposomal amphotericin B inhalation in conjunction with fluconazole can be used in patients with prolonged neutropenia (BII).

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Titel: Primary prophylaxis of invasive fungal infections in patients with haematologic malignancies. 2014 update of the recommendations of the Infectious Diseases Working Party of the German Society for Haematology and Oncology
verfasst von: Daniela Tacke
Dieter Buchheidt
Meinolf Karthaus
Stefan W. Krause
Georg Maschmeyer
Silke Neumann
Helmut Ostermann
Olaf Penack
Christina Rieger
Markus Ruhnke
Michael Sandherr
Katharina E. Schweer
Andrew J. Ullmann
Oliver A. Cornely
Publikationsdatum: 01.09.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: Annals of Hematology / Ausgabe 9/2014
Print ISSN: 0939-5555
Elektronische ISSN: 1432-0584
DOI: https://doi.org/10.1007/s00277-014-2108-y

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