Hematology and transplantation, Institut Paoli Calmettes, 232 BD SAINTE MARGUERITE, B. P. 156 13273, Marseille, France,
Curr Infect Dis Rep. 2011 Dec;13(6):528-35. doi: 10.1007/s11908-011-0214-8.
In this review, the role of secondary antifungal prophylaxis (SAP) in prevention of invasive fungal infections (IFIs) in patients with leukemia and in those receiving allogeneic hematopoietic stem cell transplantation (allo-HSCT) is discussed. A history of IFI is not an absolute contraindication for allo-HSCT or continuation of cytotoxic chemotherapy, provided that SAP is administered. We suggest that the last antifungal drug successfully used for treatment of the previous IFI is also used for SAP; during SAP, we propose an algorithm of thorough clinical, radiological and microbiological monitoring with monthly CT scan and twice weekly galactomannan assays. However, the optimal preventive strategy for patients with a prior IFI has not been defined and concerted efforts are warranted to optimize the management of affected patients.
在这篇综述中，讨论了在白血病患者和接受异基因造血干细胞移植（allo-HSCT）的患者中，二级抗真菌预防（SAP）在预防侵袭性真菌感染（IFIs）中的作用。IFI 病史并不是 allo-HSCT 或继续细胞毒性化疗的绝对禁忌，只要给予 SAP。我们建议，用于治疗先前 IFI 的最后一种成功使用的抗真菌药物也用于 SAP；在 SAP 期间，我们提出了一种彻底的临床、放射学和微生物学监测算法，每月进行 CT 扫描，每周进行两次半乳甘露聚糖检测。然而，对于先前有 IFI 的患者，最佳的预防策略尚未确定，需要共同努力优化受影响患者的管理。
