Aspergillus infections in allogeneic stem cell transplant recipients: have we made any progress?
Invasive aspergillosis (IA) is common in allogeneic SCT recipients, with an incidence of 4-10%. The majority of these infections are diagnosed several months after SCT and they are frequently associated with GVHD. The diagnosis is difficult and often delayed. Established IA is notoriously difficult to treat with a death rate of 80-90%. This review summarises recent data on this problem to assess whether there has been any progress. Effective prophylactic measures are still lacking. Severe immunosuppression is the main obstacle to the success of therapy. Recent and ongoing developments in diagnostic measures and new antifungal agents may improve treatment results to some extent, but Aspergillus infections still remain a formidable problem in allogeneic transplantation. Further studies in this field will focus on the role of various cytokines and combinations of antifungal agents.
Jantunen
E
E
Department of Medicine, Kuopio University Hospital, Kuopio, Finland.
Anttila
V-J
VJ
Ruutu
T
T
D000935:Antifungal Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control*; D015415:Biomarkers; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry / Q000382:microbiology; D004271:DNA, Fungal / Q000302:isolation & purification; D005544:Forecasting; D005690:Galactose / Q000031:analogs & derivatives; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D016867:Immunocompromised Host; D015994:Incidence; D008172:Lung Diseases, Fungal / Q000175:diagnosis / Q000209:etiology / Q000382:microbiology; D008351:Mannans / Q000032:analysis; D012307:Risk Factors; D012680:Sensitivity and Specificity; D019172:Transplantation Conditioning / Q000009:adverse effects; D014184:Transplantation, Homologous / Q000009:adverse effects*; D016896:Treatment Outcome
D000935:Antifungal Agents; D015415:Biomarkers; D004271:DNA, Fungal; D008351:Mannans; C012990:galactomannan; D005690:Galactose