SEARCH:   Advanced

Prepublished online as a Blood First Edition Paper on August 29, 2002; DOI 10.1182/blood-2002-05-1356. This Article Full Text (PDF) All Versions of this Article: 2002-05-1356v1 101/9/3365    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Cornely, O. A Articles by Karthaus, M. Search for Related Content PubMed PubMed Citation Articles by Cornely, O. A Articles by Karthaus, M. Social Bookmarking                   What's this? Submitted May 14, 2002 Accepted August 16, 2002 Evidence-based assessment of primary antifungal prophylaxis in patients with hematological malignancies Oliver A Cornely, Andrew J Ullmann, and Meinolf Karthaus* Klinik I fuer Innere Medizin, Universitaet Koeln, Koeln, Germany Medizinische Klinik III, Johannes-Gutenberg-Universitaet Mainz, Mainz, Germany Medizinische Klinik, Ev. Johannes Krankenhaus, Bielefeld, Germany * Corresponding author; email: Meinolf-Karthaus{at}johanneswerk.de. Invasive fungal infection is an increasing source of morbidity and mortality in patients with hematological malignancies, particularly those with prolonged and severe neutropenia (<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 twenty years. Non-absorbable 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. Allogeneic stem cell transplant recipients and patients with a relapsed leukemia are high-risk patient populations. In addition, well defined as certain risk factors are e.g. neutropenia >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 and safety 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: G. Hutter, S. Ganepola, E. Thiel, and I. Blau Correlation between the incidence of nosocomial aspergillosis and room reconstruction of a haematological ward Journal of Infection Prevention, November 1, 2009; 10(6): 198 - 203. [Abstract] [PDF] S. Harnicar, N. Adel, and J. Jurcic Modification of vincristine dosing during concomitant azole therapy in adult acute lymphoblastic leukemia patients Journal of Oncology Pharmacy Practice, September 1, 2009; 15(3): 175 - 182. [Abstract] [PDF] G. Maschmeyer Prevention of mould infections J. Antimicrob. Chemother., May 1, 2009; 63(suppl_1): i27 - i30. [Abstract] [Full Text] [PDF] 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]

	Copyright © 2002 by American Society of Hematology         Online ISSN: 1528-0020