免疫功能低下血液病患者真菌感染的治疗方法现状。

Current therapeutic approaches to fungal infections in immunocompromised hematological patients.

机构信息

Istituto di Ematologia, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, Rome, Italy.

出版信息

Blood Rev. 2010 Mar;24(2):51-61. doi: 10.1016/j.blre.2009.11.003. Epub 2010 Jan 6.

DOI:10.1016/j.blre.2009.11.003

PMID:20056300

Abstract

Invasive fungal infections are significant causes of morbidity and mortality in patients with hematological malignancies. Patients with acute myeloid leukemia and those who have undergone allogeneic hematopoietic stem cell transplantation are at especially high risk. Various fungal agents are responsible for this complication, but Aspergillus spp. and Candida spp. are the most frequently isolated micro-organisms; less commonly, infections could be caused by Zygomycetes or other rare molds or yeasts. Several new systemically-administered antifungal agents have been approved for clinical use since 2001; these agents include liposomal amphotericin B, voriconazole, caspofungin, and posaconazole, and they represent a major advance in antifungal therapy and have improved the prognosis of patients with hematological malignancies. This review focuses on therapeutic aspects of the management of fungal infections in hematological patients.

摘要

侵袭性真菌感染是血液系统恶性肿瘤患者发病率和死亡率的重要原因。急性髓细胞白血病患者和接受异基因造血干细胞移植的患者风险特别高。各种真菌病原体均可导致这种并发症，但曲霉菌属和假丝酵母菌属是最常分离出的微生物；较少见的情况下，也可能由接合菌或其他罕见的霉菌或酵母菌引起感染。自 2001 年以来，已有几种新的全身性抗真菌药物获得批准用于临床，包括脂质体两性霉素 B、伏立康唑、卡泊芬净和泊沙康唑，这是抗真菌治疗的重大进展，改善了血液系统恶性肿瘤患者的预后。这篇综述重点介绍血液系统患者真菌感染管理的治疗方面。