title: Primary prophylaxis of invasive fungal diseases in allogeneic stem cell transplantation: revised recommendations from a consensus process by Gruppo Italiano Trapianto Midollo Osseo (GITMO).
abstract: This document updates and expands the recommendations on primary prophylaxis of invasive fungal diseases (IFD) in allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients, published in 2009 by the Gruppo Italiano Trapianto Midollo Osseo (GITMO). A consensus process was undertaken to describe and evaluate current information and practice regarding risk stratification and primary antifungal prophylaxis during the pre-engraftment and postengraftment phases after allo-HSCT. The revised recommendations were based on the evaluation of recent literature including a large, prospective, multicenter epidemiological study of allo-HSCT recipients conducted among the GITMO transplantation centers during the period of 2008 to 2010. It is intended as a guide for the identification of types and phases of transplantation at low, standard, and high risk for IFD, according to the underlying disease, transplantation, and post-transplantation factors. The risk stratification was the critical determinant of the primary antifungal approach for allo-HSCT recipients.
authors.affiliation: Department of Hematology, Azienda Policlinico Umberto I, Sapienza University of Rome, Rome, Italy. Electronic address: girmenia@bce.uniroma1.it.
authors.forename: Corrado
authors.initials: C
authors.lastname: Girmenia
authors.affiliation: Center for Q1 the Study of Myelofibrosis, IRCCS Fondazione Policlinico S. Matteo, University of Pavia, Pavia, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Barosi
authors.affiliation: GIMEMA Foundation, Rome, Italy.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Piciocchi
authors.affiliation: Stem Cell Transplant Unit, Fondazione Policlinico Tor Vergata, Tor Vergata University, Rome, Italy.
authors.forename: William
authors.initials: W
authors.lastname: Arcese
authors.affiliation: Hematology and Bone Marrow Transplant Center, Ospedale Maggiore, Parma, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Aversa
authors.affiliation: Division of Hematology II, IRCCS S. Martino University Hospital e IST, Genoa, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Bacigalupo
authors.affiliation: Institute of Hematology and Medical Oncology, L. e A Seragnoli, Policlinico S.Orsola Malpigli, Bologna, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Bandini
authors.affiliation: Department of Hematology, A.O. di Careggi, University of Florence, Florence, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Bosi
authors.affiliation: Department of Oncology and Hematology, A.O. Citta' della Salute e della Scienza di Torino, P.O. Molinette, Torino, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Busca
authors.affiliation: Division of Infectious Diseases and Bone Marrow Transplant Unit, Giannina Gaslini Institute, Genoa, Italy.
authors.forename: Elio
authors.initials: E
authors.lastname: Castagnola
authors.affiliation: AOU Meyer Children Hospital Medical Direction, Florence, Italy.
authors.forename: Desiree
authors.initials: D
authors.lastname: Caselli
authors.affiliation: Pediatric Onco-hematology Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Cesaro
authors.affiliation: Hematology and Bone Marrow Transplant Unit, San Raffaele Hospital, Milan, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Ciceri
authors.affiliation: Pediatrics and Pediatric Hematology Unit, Az. Osp. S.Camillo-Forlanini, Rome, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Locasciulli
authors.affiliation: Onco-hematology Unit, Ospedale Pediatrico Bambino Gesù, Rome, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Locatelli
authors.affiliation: Department of Infectious Diseases, IRCCS S. Martino University Hospital e IST, Genoa, Italy.
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Mikulska
authors.affiliation: Institute of Hematology, Policlinic A. Gemelli, Sacred Heath Catholic University, Rome, Italy.
authors.forename: Livio
authors.initials: L
authors.lastname: Pagano
authors.affiliation: Oncology, Hematology and Hematopoietic Stem Cell Transplant Program, U.O. Pediatrics-Prof. Pession, S. Orsola-Malpighi, University of Bologna, Bologna, Italy.
authors.forename: Arcangelo
authors.initials: A
authors.lastname: Prete
authors.affiliation: Division of Hematology II, IRCCS S. Martino University Hospital e IST, Genoa, Italy.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Raiola
authors.affiliation: Division of Hematology, Azienda Ospedaliera Giovanni XXIII, Bergamo, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Rambaldi
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D007558:Italy; D009181:Mycoses / Q000517:prevention & control*; D019172:Transplantation Conditioning / Q000379:methods*; D014184:Transplantation, Homologous / Q000379:methods*
chemical_list: D000935:Antifungal Agents
keywords: Allogeneic hematopoietic stem cell transplantation (HSCT); Antifungal prophylaxis; Consensus; Fungal infections