[既往有侵袭性真菌病的血液系统恶性肿瘤患者的二线抗真菌预防治疗]
[Secondary antifungal prophylaxis in hematological malignancy patients with previous invasive fungal disease].
作者信息
Liu Ming-Juan, Huang Wen-Rong, Yu Li
机构信息
Department of Hematology and BMT center, Chinese PLA General Hospital, Beijing 100853, China.
Department of Hematology, 309 Hospital of Chinese People's Liberation Army, Beijing 100091, China.
出版信息
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2015 Apr;23(2):596-600. doi: 10.7534/j.issn.1009-2137.2015.02.059.
Invasive fungal disease (IFD) causes a high morbidity and mortality in patients with hematological malignancies. Reactivation of IFD after chemotherapy or hematopoietic stem cell transplantation (HSCT) is very common and associated with poor prognosis. Secondary antifungal prophylaxis (SAP) is effective in preventing IFD recurrence. With effective SAP, a history of IFD is not an absolute contraindication to allogeneic HSCT or continuation of high-dose chemotherapy. In recent years, a variety of antifungal drugs such as voriconazole, itraconazole, AmB and caspofungin have been found to be effective for SAP. However, its management during granulocytopenia and immunosuppression remains challenging. This review summarizes the current status of SAP in patients with hematological malignancies.
侵袭性真菌病（IFD）在血液系统恶性肿瘤患者中可导致高发病率和死亡率。化疗或造血干细胞移植（HSCT）后IFD复发非常常见，且与预后不良相关。二级抗真菌预防（SAP）可有效预防IFD复发。有了有效的SAP，IFD病史并非异基因HSCT或继续进行大剂量化疗的绝对禁忌证。近年来，已发现多种抗真菌药物，如伏立康唑、伊曲康唑、两性霉素B和卡泊芬净对SAP有效。然而，在粒细胞减少和免疫抑制期间对其进行管理仍具有挑战性。本综述总结了血液系统恶性肿瘤患者SAP的现状。
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