|
|
Prepublished online as a Blood First Edition Paper on August 29, 2002; DOI 10.1182/blood-2002-05-1356.
 Previous Article | Table of Contents | Next Article 
Blood, 1 May 2003, Vol. 101, No. 9, pp. 3365-3372
REVIEW ARTICLE
Evidence-based assessment of primary antifungal prophylaxis
in patients with hematologic malignancies
Oliver A. Cornely,
Andrew
J. Ullmann, and
Meinolf Karthaus
From the Klinik I für Innere Medizin, Klinikum
der Universität Köln, Köln, Germany;
Klinikum der Johannes Gutenberg-Universität, III, Medizinische
Klinik und Poliklinik, Mainz, Germany; and Medizinische
Klinik II, Ev Johannes-Krankenhaus, Bielefeld,
Germany.
Invasive fungal infection is an increasing source of morbidity and
mortality in patients with hematologic malignancies, particularly those
with prolonged and severe neutropenia (absolute white blood cell count
< 100/µL). Early diagnosis of invasive fungal infection is
difficult, suggesting that antifungal prophylaxis could be the best
approach for neutropenic patients undergoing intensive myelosuppressive
chemotherapy. Consequently, antifungal prophylaxis has been extensively
studied for more than 20 years. Nonabsorbable polyenes reduce
superficial mycoses but are not effective in preventing or treating
invasive fungal infections. Intravenous amphotericin B and the newer
azoles were used in numerous clinical trials, but the value of
antifungal prophylaxis in defined risk groups with cancer is still open
to discussion. Recipients of allogeneic stem cell transplants and
patients with a relapsed leukemia are high-risk patient populations. In
addition, certain risk factors are well defined, for example,
neutropenia more than 10 days, corticosteroid therapy, sustained
immunosuppression, and graft-versus-host disease. In contrast to study
efforts, evidence-based recommendations on the clinical use of
antifungal prophylaxis according to risk groups are rare. The objective
of this review of 50 studies accumulating more than 9000 patients is to
assess evidence-based criteria with regard to the efficacy of
antifungal prophylaxis in neutropenic cancer patients.
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati What's this?
This article has been cited by other articles:
|
|
|
|
 
R. G. Masterton, A. Galloway, G. French, M. Street, J. Armstrong, E. Brown, J. Cleverley, P. Dilworth, C. Fry, A. D. Gascoigne, et al.
Guidelines for the management of hospital-acquired pneumonia in the UK: Report of the Working Party on Hospital-Acquired Pneumonia of the British Society for Antimicrobial Chemotherapy
J. Antimicrob. Chemother.,
July 1, 2008;
62(1):
5 - 34.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
O. A. Cornely, A. Bohme, D. Reichert, S. Reuter, G. Maschmeyer, J. Maertens, D. Buchheidt, M. Paluszewska, D. Arenz, U. Bethe, et al.
Risk factors for breakthrough invasive fungal infection during secondary prophylaxis
J. Antimicrob. Chemother.,
April 1, 2008;
61(4):
939 - 946.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
O. A. Cornely, J. Maertens, D. J. Winston, J. Perfect, A. J. Ullmann, T. J. Walsh, D. Helfgott, J. Holowiecki, D. Stockelberg, Y.-T. Goh, et al.
Posaconazole vs. Fluconazole or Itraconazole Prophylaxis in Patients with Neutropenia
N. Engl. J. Med.,
January 25, 2007;
356(4):
348 - 359.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
O. Penack, S. Schwartz, P. Martus, M. Reinwald, M. Schmidt-Hieber, E. Thiel, and I. W. Blau
Low-dose liposomal amphotericin B in the prevention of invasive fungal infections in patients with prolonged neutropenia: results from a randomized, single-center trial
Ann. Onc.,
August 1, 2006;
17(8):
1306 - 1312.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. A. Enoch, H. A. Ludlam, and N. M. Brown
Invasive fungal infections: a review of epidemiology and management options.
J. Med. Microbiol.,
July 1, 2006;
55(Pt 7):
809 - 818.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
O. A. Cornely, A. J. Ullmann, and M. Karthaus
Comment on: Evidence-based review of antifungal prophylaxis in neutropenic patients with haematological malignancies
J. Antimicrob. Chemother.,
January 1, 2006;
57(1):
151 - 152.
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Glasmacher and A. Prentice
The role of meta-analysis in the evaluation of antifungal prophylaxis: authors' response
J. Antimicrob. Chemother.,
January 1, 2006;
57(1):
152 - 154.
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Karthaus, O. A. Cornely, and A. J. Ullmann
Itraconazole versus Fluconazole for Antifungal Prophylaxis
Ann Intern Med,
April 6, 2004;
140(7):
579 - 580.
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. de Pauw
Preventative use of antifungal drugs in patients treated for cancer
J. Antimicrob. Chemother.,
February 1, 2004;
53(2):
130 - 132.
[Abstract]
[Full Text]
[PDF]
|
|
|
| |
