Antifungal prophylaxis among allogeneic hematopoietic stem cell transplant recipients: Current issues and new agents

Lynne Strasfeld, David M. Weinstock

Research output: Contribution to journalReview article

15 Scopus citations

Abstract

Invasive candidiasis and invasive mold infections cause significant morbidity and mortality in the hematopoietic stem cell transplant population, in particular in recipients of allografts. The introduction of a variety of new antifungal compounds over the past decade has focused attention on prophylactic strategies as a means to decrease the burden of invasive fungal infections (IFIs). Until recently, fluconazole has been the standard agent for prophylaxis before and after engraftment. In 2005, the echinocandin micafungin received US FDA approval for prophylaxis against IFIs in stem cell transplant recipients during the neutropenic period prior to engraftment. In patients with substantial risk for invasive mold infection, many centers now use a mold-active antifungal agent (e.g., a triazole such as itraconazole, voriconazole or posaconazole, or an echinocandin) as prophylaxis after engraftment. Several recent studies have highlighted the efficacy of these newer agents in preventing IFIs in these highly immunocompromised patients. This review will discuss current issues in IFI and new agents available for prophylaxis in allogeneic hematopoietic stem cell transplant recipients.

Original languageEnglish (US)
Pages (from-to)457-468
Number of pages12
JournalExpert Review of Anti-Infective Therapy
Volume4
Issue number3
DOIs
StatePublished - Jun 1 2006

Keywords

  • Antifungals
  • Prophylaxis
  • Stem cell transplant
  • Voriconazole

ASJC Scopus subject areas

  • Microbiology
  • Microbiology (medical)
  • Infectious Diseases
  • Virology

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