Departments of Medicine and Oncology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
Curr Opin Oncol. 2010 Mar;22(2):138-42. doi: 10.1097/CCO.0b013e328335a755.
Fungal infections that occur after hematopoietic stem cell transplant and therapies for hematologic malignancies contribute to poor outcomes. In the recent year, studies have focused on updating epidemiologic data, providing an understanding of immunogenetic risks for infection, and optimizing prevention and treatment strategies; these studies will be reviewed.
Contributions to our understanding of epidemiology have come from multicenter studies. Results demonstrate variability in the numbers of diagnosed invasive aspergillosis cases in oncology centers, and a persistent, although relatively low rate of invasive candidiasis. Both multiple and single-center studies are demonstrating improved outcomes of treating invasive aspergillosis. Several important studies have outlined the importance of immunogenetics in conferring risks for invasive fungal infections. There have been numerous studies recently published that assist with our understanding of preventive strategies, questioning the utility of pretherapy screening computed tomography scans and masks. Several important randomized trials compared alternative strategies to standard 'empirical' therapies. Finally, several studies were performed that outline complexity in administering new azole antifungals, assisting in optimizing outcomes.
Studies published in the most recent year outline several important advances in our understanding of epidemiology, prevention and treatment of invasive fungal infections.
造血干细胞移植和血液系统恶性肿瘤治疗后发生的真菌感染可导致不良结局。在最近的一年中，研究重点是更新流行病学数据，了解感染的免疫遗传风险，并优化预防和治疗策略；这些研究将被综述。
来自多中心研究的结果加深了我们对流行病学的理解。结果表明，在肿瘤中心诊断侵袭性曲霉菌病的病例数量存在差异，侵袭性念珠菌病的发生率虽然持续存在，但相对较低。多项多中心和单中心研究都表明，侵袭性曲霉菌病的治疗效果有所改善。一些重要的研究表明，免疫遗传学在赋予侵袭性真菌感染风险方面具有重要作用。最近发表了许多研究，帮助我们理解预防策略，质疑治疗前 CT 扫描和口罩的效用。几项重要的随机试验比较了替代标准“经验性”治疗策略的方法。最后，进行了一些研究，阐述了管理新型唑类抗真菌药物的复杂性，有助于优化治疗效果。
最近发表的研究概述了我们在侵袭性真菌感染的流行病学、预防和治疗方面的理解的几个重要进展。
