Treatment of invasive fungal infections in cancer patients—Recommendations of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Oncology (DGHO)

Angelika Böhme (1) , Markus Ruhnke (2) , Dieter Buchheidt (3) , Oliver A. Cornely (4) , Herrmann Einsele (5) , Ruxandra Enzensberger (6) , Holger Hebart (7) , Werner Heinz (8) , Christian Junghanss (9) , Meinolf Karthaus (10) , William Krüger (11) , Utz Krug (12) , Thomas Kubin (13) , Olaf Penack (14) , Dietmar Reichert (15) , Stefan Reuter (16) , Gerda Silling (17) , Thomas Südhoff (18) , Andrew J. Ullmann (19) , Georg Maschmeyer (20)

1 ONKOLOGIKUM, Frankfurt am Museumsufer
2 Abt. Onkologie und Hämatologie, Med. Klinik u. Poliklinik II
3 III. Medizinische Klinik
4 Klinik I für Innere Medizin und Zentrum für Klinische Studien (ZKS) 01KN0706
5 Medizinische Klinik und Poliklinik II
6 Institut für Medizinische Mikrobiologie und Krankenhaushygiene
7 Zentrum für Innere Medizin
8 Schwerpunkt Infektiologie, Medizinische Klinik und Poliklinik II
9 Abt. Hämatologie und Onkologie. Klinik und Poliklinik für Innere Medizin
10 Abt. Hämatologie/Onkologie
11 Medizinische Klinik C
12 Medizinische Klinik A
13 Hämatologie/Onkologie
14 Klinik für Hämatologie und Onkologie
15 Hämatologisch-Onkologische Gemeinschaftspraxis Dr. Reichert/Dr. Janssen
16 Klinik für Gastroenterologie, Hepatologie und Infektiologie
17 Innere Medizin A
18 II. Medizinische Klinik
19 3. Medizinische Abteilung
20 Medizinische Klinik, Hämatologie und Onkologie

Invasive fungal infections are a main cause of morbidity and mortality in cancer patients undergoing intensive chemotherapy regimens. Early antifungal treatment is mandatory to improve survival. Today, a number of effective and better-tolerated but more expensive antifungal agents compared to the former gold standard amphotericin B deoxycholate are available. Clinical decision-making must consider results from numerous studies and published guidelines, as well as licensing status and cost pressure. New developments in antifungal prophylaxis improving survival rates result in a continuous need for actualization. The treatment options for invasive infections include fluconazole, voriconazole, and amphotericin B and its lipid formulations, as well as echinocandins. Voriconazole, amphotericin B, amphotericin B lipid formulations, caspofungin, itraconazole, and posaconazole are available for the treatment of invasive aspergillosis. Additional procedures, such as surgical interventions, immunoregulatory therapy, and granulocyte transfusions, have to be considered. The Infectious Diseases Working Party of the German Society of Hematology and Oncology here presents its 2008 recommendations discussing the dos and do-nots, as well as the problems and possible solutions, of evidence criteria selection.

Mots clés: Cancer; Invasive fungal infections; Antifungals

Angelika Böhme, Markus Ruhnke, Dieter Buchheidt, Oliver A. Cornely, Herrmann Einsele, et al.. Treatment of invasive fungal infections in cancer patients—Recommendations of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Oncology (DGHO). Annals of Hematology, 2008, 88 (2), pp.97-110. ⟨10.1007/s00277-008-0622-5⟩. ⟨hal-00477985⟩