Ruhnke, Markus, Cornely, Oliver A., Schmidt-Hieber, Martin, Alakel, Nael, Boell, Boris, Buchheidt, Dieter, Christopeit, Maximilian, Hasenkamp, Justin, Heinz, Werner J., Hentrich, Marcus, Karthaus, Meinolf, Koldehoff, Michael, Maschmeyer, Grorg, Panse, Jens, Penack, Olaf, Schleicher, Jan, Teschner, Daniel ORCID: 0000-0001-7351-8060, Ullmann, Andrew John, Vehreschild, Maria, von Lilienfeld-Toal, Marie, Weissinger, Florian and Schwartz, Stefan ORCID: 0000-0001-8833-5793 (2020). Treatment of invasive fungal diseases in cancer patients-Revised 2019 Recommendations of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Oncology (DGHO). Mycoses, 63 (7). S. 653 - 683. HOBOKEN: WILEY. ISSN 1439-0507

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Abstract

Background Invasive fungal diseases remain a major cause of morbidity and mortality in cancer patients undergoing intensive cytotoxic therapy. The choice of the most appropriate antifungal treatment (AFT) depends on the fungal species suspected or identified, the patient's risk factors (eg length and depth of granulocytopenia) and the expected side effects. Objectives Since the last edition of recommendations for 'Treatment of invasive fungal infections in cancer patients' of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO) in 2013, treatment strategies were gradually moving away from solely empirical therapy of presumed or possible invasive fungal diseases (IFDs) towards pre-emptive therapy of probable IFD. Methods The guideline was prepared by German clinical experts for infections in cancer patients in a stepwise consensus process. MEDLINE was systematically searched for English-language publications from January 1975 up to September 2019 using the key terms such as 'invasive fungal infection' and/or 'invasive fungal disease' and at least one of the following: antifungal agents, cancer, haematological malignancy, antifungal therapy, neutropenia, granulocytopenia, mycoses, aspergillosis, candidosis and mucormycosis. Results AFT of IFDs in cancer patients may include not only antifungal agents but also non-pharmacologic treatment. In addition, the armamentarium of antifungals for treatment of IFDs has been broadened (eg licensing of isavuconazole). Additional antifungals are currently under investigation or in clinical trials. Conclusions Here, updated recommendations for the treatment of proven or probable IFDs are given. All recommendations including the levels of evidence are summarised in tables to give the reader rapid access to key information.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Ruhnke, MarkusUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cornely, Oliver A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schmidt-Hieber, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Alakel, NaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Boell, BorisUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Buchheidt, DieterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Christopeit, MaximilianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hasenkamp, JustinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Heinz, Werner J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hentrich, MarcusUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Karthaus, MeinolfUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Koldehoff, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Maschmeyer, GrorgUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Panse, JensUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Penack, OlafUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schleicher, JanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Teschner, DanielUNSPECIFIEDorcid.org/0000-0001-7351-8060UNSPECIFIED
Ullmann, Andrew JohnUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Vehreschild, MariaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
von Lilienfeld-Toal, MarieUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Weissinger, FlorianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schwartz, StefanUNSPECIFIEDorcid.org/0000-0001-8833-5793UNSPECIFIED
URN: urn:nbn:de:hbz:38-333955
DOI: 10.1111/myc.13082
Journal or Publication Title: Mycoses
Volume: 63
Number: 7
Page Range: S. 653 - 683
Date: 2020
Publisher: WILEY
Place of Publication: HOBOKEN
ISSN: 1439-0507
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
LIPOSOMAL AMPHOTERICIN-B; ACUTE MYELOID-LEUKEMIA; COMBINATION ANTIFUNGAL THERAPY; HIGH-RISK PATIENTS; CHRONIC GRANULOMATOUS-DISEASE; CELL TRANSPLANT RECIPIENTS; CENTRAL VENOUS CATHETER; HIGH-DOSE FLUCONAZOLE; REVERSED HALO SIGN; SCEDOSPORIUM-PROLIFICANS INFECTIONMultiple languages
Dermatology; MycologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/33395

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