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癌症相关感染的预防和治疗,第 3.2024 版,NCCN 肿瘤学临床实践指南。

Prevention and Treatment of Cancer-Related Infections, Version 3.2024, NCCN Clinical Practice Guidelines in Oncology.

机构信息

1Dana-Farber Cancer Institute.

2Huntsman Cancer Institute at the University of Utah.

出版信息

J Natl Compr Canc Netw. 2024 Nov;22(9):617-644. doi: 10.6004/jnccn.2024.0056.

Abstract

There is an increased risk of infection in patients with cancer that results in higher morbidity and mortality. Several risk factors can predispose these patients to infectious complications. Some such factors include immunocompromised states like neutropenia, allogeneic hematopoietic cell transplantation, and graft-versus-host disease, while others include immunosuppressive agents like corticosteroids, purine analogs, monoclonal antibodies, and other emerging cancer therapeutics like CAR T-cell therapy. The NCCN Guidelines for the Prevention and Treatment of Cancer-Related Infections address infection concerns that may be observed in these immunocompromised populations and characterize the major pathogens to which patients with cancer are susceptible, with a focus on the prevention, diagnosis, and treatment of major common and opportunistic infections. This paper highlights 2 recently updated sections of the guidelines, namely, infection concerns related to CAR T-cell therapy and antimicrobial prophylaxis recommendations, including vaccination, in patients at high-risk for infections.

摘要

癌症患者感染风险增加,导致发病率和死亡率更高。一些风险因素可使这些患者易发生感染并发症。一些此类因素包括免疫功能低下,如中性粒细胞减少症、异基因造血细胞移植和移植物抗宿主病,而其他因素包括免疫抑制剂,如皮质类固醇、嘌呤类似物、单克隆抗体和其他新兴的癌症治疗方法,如 CAR T 细胞疗法。NCCN 癌症相关感染预防和治疗指南解决了这些免疫功能低下人群中可能观察到的感染问题,并描述了癌症患者易感染的主要病原体,重点是预防、诊断和治疗常见和机会性感染。本文重点介绍了指南中最近更新的两个部分,即与 CAR T 细胞疗法相关的感染问题和高危感染患者的抗菌预防建议,包括疫苗接种。

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