Journal Article

Clinical Issues Regarding Relapsing Aspergillosis and the Efficacy of Secondary Antifungal Prophylaxis in Patients with Hematological Malignancies

Nikolaos V. Sipsas and Dimitrios P. Kontoyiannis

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 42, issue 11, pages 1584-1591
Published in print June 2006 | ISSN: 1058-4838
Published online June 2006 | e-ISSN: 1537-6591 | DOI: https://dx.doi.org/10.1086/503844
Clinical Issues Regarding Relapsing Aspergillosis and the Efficacy of Secondary Antifungal Prophylaxis in Patients with Hematological Malignancies

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Advancements in early diagnosis and the introduction of effective agents have improved the rates of response of aspergillosis to primary antifungal therapy. These changes allow the subsequent continuation of cytotoxic chemotherapy and/or performance of hematopoietic stem cell transplantation in an increasing number of patients with hematological malignancies. These developments have increased interest in secondary prophylaxis of aspergillosis, because the resumption of myelotoxic chemotherapy in these patients is associated with high rates of relapse of this opportunistic mycosis in the absence of prophylaxis. However, the risk factors for relapsing invasive aspergillosis and the strategies for reducing risk are not well defined. Furthermore, differentiating aspergillosis relapse from reinfection with a new Aspergillus isolate is problematic when using the available laboratory tools. We summarize the existing knowledge regarding the pathogenesis of, risk factors for, and natural history of relapsing invasive aspergillosis and review the limited data regarding the role of secondary antifungal prophylaxis.

Journal Article.  4995 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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