Tissot Frederic, Agrawal Samir, Pagano Livio, Petrikkos Georgios, Groll Andreas H, Skiada Anna, Lass-Flörl Cornelia, Calandra Thierry, Viscoli Claudio, Herbrecht Raoul
Infectious Diseases Service, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland
Division of Haemato-Oncology, St Bartholomew's Hospital and Blizard Institute, Queen Mary University, London, UK.
Haematologica. 2017 Mar;102(3):433-444. doi: 10.3324/haematol.2016.152900. Epub 2016 Dec 23.
The European Conference on Infections in Leukemia (ECIL) provides recommendations for diagnostic strategies and prophylactic, pre-emptive or targeted therapy strategies for various types of infection in patients with hematologic malignancies or hematopoietic stem cell transplantation recipients. Meetings are held every two years since 2005 and evidence-based recommendations are elaborated after evaluation of the literature and discussion among specialists of nearly all European countries. In this manuscript, the ECIL group presents the 2015-update of the recommendations for the targeted treatment of invasive candidiasis, aspergillosis and mucormycosis. Current data now allow a very strong recommendation in favor of echinocandins for first-line therapy of candidemia irrespective of the underlying predisposing factors. Anidulafungin has been given the same grading as the other echinocandins for hemato-oncological patients. The beneficial role of catheter removal in candidemia is strengthened. guidelines now recommend the use of either voriconazole or isavuconazole for first-line treatment of invasive aspergillosis, while first-line combination antifungal therapy is not routinely recommended. As only few new data were published since the last ECIL guidelines, no major changes were made to mucormycosis recommendations.
欧洲白血病感染会议（ECIL）针对血液系统恶性肿瘤患者或造血干细胞移植受者的各类感染，提供了诊断策略以及预防性、抢先性或靶向治疗策略的相关建议。自2005年起，会议每两年举行一次，在评估文献并经几乎所有欧洲国家的专家讨论后，制定基于证据的建议。在本手稿中，ECIL小组介绍了侵袭性念珠菌病、曲霉病和毛霉病靶向治疗建议的2015年更新内容。目前的数据有力支持不论潜在易感因素如何，棘白菌素类药物作为念珠菌血症一线治疗药物的推荐。对于血液肿瘤患者，阿尼芬净与其他棘白菌素类药物具有相同的分级。拔除导管在念珠菌血症治疗中的有益作用得到强化。指南现推荐伏立康唑或艾沙康唑作为侵袭性曲霉病的一线治疗药物，而不常规推荐一线联合抗真菌治疗。由于自上次ECIL指南发布以来仅有少量新数据公布，毛霉病的治疗建议未作重大改动。
