American Society of Transplantation and Cellular Therapy Series, 2: Management and Prevention of Aspergillosis in Hematopoietic Cell Transplantation Recipients

Overview

Journal Transplant Cell Ther

Date 2021 Mar 30

PMID 33781516

Citations 11

Authors

Sanjeet S Dadwal

Tobias M Hohl

Cynthia E Fisher

Michael Boeckh

Genofeva Papanicolaou

Paul A Carpenter

Brian T Fisher

Monica A Slavin

D P Kontoyiannis

Affiliations

Soon will be listed here.

Abstract

The Practice Guidelines Committee of the American Society of Transplantation and Cellular Therapy partnered with its Transplant Infectious Disease Special Interest Group to update its 2009 compendium-style infectious disease guidelines for hematopoietic cell transplantation (HCT). A completely fresh approach was taken with the goal of better serving clinical providers by publishing each standalone topic in the infectious disease series as a concise format of frequently asked questions (FAQs), tables, and figures. Adult and pediatric infectious disease and HCT content experts developed, then answered FAQs, and finalized topics with harmonized recommendations that were made by assigning an A through E strength of recommendation paired with a level of supporting evidence graded I through III. This second guideline in the series focuses on invasive aspergillosis, a potentially life-threatening infection in the peri-HCT period. The relevant risk factors, diagnostic considerations, and prophylaxis and treatment approaches are reviewed.

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References

DHaese J, Theunissen K, Vermeulen E, Schoemans H, De Vlieger G, Lammertijn L . Detection of galactomannan in bronchoalveolar lavage fluid samples of patients at risk for invasive pulmonary aspergillosis: analytical and clinical validity. J Clin Microbiol. 2012; 50(4):1258-63. PMC: 3318563. DOI: 10.1128/JCM.06423-11. View

Katragkou A, Fisher B, Groll A, Roilides E, Walsh T . Diagnostic Imaging and Invasive Fungal Diseases in Children. J Pediatric Infect Dis Soc. 2017; 6(suppl_1):S22-S31. DOI: 10.1093/jpids/pix055. View

King J, Pana Z, Lehrnbecher T, Steinbach W, Warris A . Recognition and Clinical Presentation of Invasive Fungal Disease in Neonates and Children. J Pediatric Infect Dis Soc. 2017; 6(suppl_1):S12-S21. PMC: 5907856. DOI: 10.1093/jpids/pix053. View

Goodman J, Winston D, Greenfield R, Chandrasekar P, Fox B, Kaizer H . A controlled trial of fluconazole to prevent fungal infections in patients undergoing bone marrow transplantation. N Engl J Med. 1992; 326(13):845-51. DOI: 10.1056/NEJM199203263261301. View

Dadwal S, Tegtmeier B, Liu X, Frankel P, Ito J, Forman S . Impact of pretransplant serum ferritin level on risk of invasive mold infection after allogeneic hematopoietic stem cell transplantation. Eur J Haematol. 2014; 94(3):235-42. DOI: 10.1111/ejh.12421. View

Decembrino N, Perruccio K, Zecca M, Colombini A, Calore E, Muggeo P . A Case Series and Literature Review of Isavuconazole Use in Pediatric Patients with Hemato-oncologic Diseases and Hematopoietic Stem Cell Transplantation. Antimicrob Agents Chemother. 2019; 64(3). PMC: 7038308. DOI: 10.1128/AAC.01783-19. View

Marr K, Seidel K, Slavin M, Bowden R, Schoch H, Flowers M . Prolonged fluconazole prophylaxis is associated with persistent protection against candidiasis-related death in allogeneic marrow transplant recipients: long-term follow-up of a randomized, placebo-controlled trial. Blood. 2000; 96(6):2055-61. View

Rose S, Vallabhajosyula S, Velez M, Fedorko D, VanRaden M, Gea-Banacloche J . The utility of bronchoalveolar lavage beta-D-glucan testing for the diagnosis of invasive fungal infections. J Infect. 2014; 69(3):278-83. PMC: 4127351. DOI: 10.1016/j.jinf.2014.04.008. View

Cordonnier C, Rovira M, Maertens J, Olavarria E, Faucher C, Bilger K . Voriconazole for secondary prophylaxis of invasive fungal infections in allogeneic stem cell transplant recipients: results of the VOSIFI study. Haematologica. 2010; 95(10):1762-8. PMC: 2948103. DOI: 10.3324/haematol.2009.020073. View

10.

Marr K, Carter R, Crippa F, Wald A, Corey L . Epidemiology and outcome of mould infections in hematopoietic stem cell transplant recipients. Clin Infect Dis. 2002; 34(7):909-17. DOI: 10.1086/339202. View

11.

Georgiadou S, Sipsas N, Marom E, Kontoyiannis D . The diagnostic value of halo and reversed halo signs for invasive mold infections in compromised hosts. Clin Infect Dis. 2011; 52(9):1144-55. PMC: 3106265. DOI: 10.1093/cid/cir122. View

12.

Zaoutis T, Jafri H, Huang L, Locatelli F, Barzilai A, Ebell W . A prospective, multicenter study of caspofungin for the treatment of documented Candida or Aspergillus infections in pediatric patients. Pediatrics. 2009; 123(3):877-84. DOI: 10.1542/peds.2008-1158. View

13.

Bowen C, Tallman G, Hakki M, Lewis J . Isavuconazole to prevent invasive fungal infection in immunocompromised adults: Initial experience at an academic medical centre. Mycoses. 2019; 62(8):665-672. DOI: 10.1111/myc.12924. View

14.

Schwartz S, Cornely O, Hamed K, Marty F, Maertens J, Rahav G . Isavuconazole for the treatment of patients with invasive fungal diseases involving the central nervous system. Med Mycol. 2019; 58(4):417-424. PMC: 7261609. DOI: 10.1093/mmy/myz103. View

15.

Lestrade P, Bentvelsen R, Schauwvlieghe A, Schalekamp S, van der Velden W, Kuiper E . Voriconazole Resistance and Mortality in Invasive Aspergillosis: A Multicenter Retrospective Cohort Study. Clin Infect Dis. 2018; 68(9):1463-1471. DOI: 10.1093/cid/ciy859. View

16.

Wingard J, Carter S, Walsh T, Kurtzberg J, Small T, Baden L . Randomized, double-blind trial of fluconazole versus voriconazole for prevention of invasive fungal infection after allogeneic hematopoietic cell transplantation. Blood. 2010; 116(24):5111-8. PMC: 3012532. DOI: 10.1182/blood-2010-02-268151. View

17.

Puerta-Alcalde P, Champlin R, Kontoyiannis D . How I perform hematopoietic stem cell transplantation on patients with a history of invasive fungal disease. Blood. 2020; 136(24):2741-2753. PMC: 7731790. DOI: 10.1182/blood.2020005884. View

18.

Lamoth F, Kontoyiannis D . Therapeutic Challenges of Non- Invasive Mold Infections in Immunosuppressed Patients. Antimicrob Agents Chemother. 2019; 63(11). PMC: 6811444. DOI: 10.1128/AAC.01244-19. View

19.

Fontana L, Perlin D, Zhao Y, Noble B, Lewis J, Strasfeld L . Isavuconazole Prophylaxis in Patients With Hematologic Malignancies and Hematopoietic Cell Transplant Recipients. Clin Infect Dis. 2019; 70(5):723-730. PMC: 7931837. DOI: 10.1093/cid/ciz282. View

20.

Andes D, Kovanda L, Desai A, Kitt T, Zhao M, Walsh T . Isavuconazole Concentration in Real-World Practice: Consistency with Results from Clinical Trials. Antimicrob Agents Chemother. 2018; 62(7). PMC: 6021624. DOI: 10.1128/AAC.00585-18. View