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Treatment of invasive fungal infections in cancer patients—Recommendations of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Oncology (DGHO)

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Abstract

Invasive fungal infections are a main cause of morbidity and mortality in cancer patients undergoing intensive chemotherapy regimens. Early antifungal treatment is mandatory to improve survival. Today, a number of effective and better-tolerated but more expensive antifungal agents compared to the former gold standard amphotericin B deoxycholate are available. Clinical decision-making must consider results from numerous studies and published guidelines, as well as licensing status and cost pressure. New developments in antifungal prophylaxis improving survival rates result in a continuous need for actualization. The treatment options for invasive Candida infections include fluconazole, voriconazole, and amphotericin B and its lipid formulations, as well as echinocandins. Voriconazole, amphotericin B, amphotericin B lipid formulations, caspofungin, itraconazole, and posaconazole are available for the treatment of invasive aspergillosis. Additional procedures, such as surgical interventions, immunoregulatory therapy, and granulocyte transfusions, have to be considered. The Infectious Diseases Working Party of the German Society of Hematology and Oncology here presents its 2008 recommendations discussing the dos and do-nots, as well as the problems and possible solutions, of evidence criteria selection.

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Authors and Affiliations

  1. ONKOLOGIKUM, Frankfurt am Museumsufer, Schaubstraße 16, 60596, Frankfurt, Germany

    Angelika Böhme

  2. Abt. Onkologie und Hämatologie, Med. Klinik u. Poliklinik II, Charité Universitätsmedizin, Campus Charité Mitte, Charitéplatz 1, 10117, Berlin, Germany

    Markus Ruhnke

  3. III. Medizinische Klinik, Universitätsklinikum Mannheim GmbH, Theodor-Kutzer-Ufer 1–3, 68167, Mannheim, Germany

    Dieter Buchheidt

  4. Klinik I für Innere Medizin und Zentrum für Klinische Studien (ZKS) 01KN0706, Klinikum der Universität Köln, Kerpener Str. 62, 50937, Köln, Germany

    Oliver A. Cornely

  5. Medizinische Klinik und Poliklinik II, Universitätsklinikum Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Germany

    Herrmann Einsele

  6. Institut für Medizinische Mikrobiologie und Krankenhaushygiene, J.W. Goethe-Universität, Paul-Ehrlich-Str.40, 60596, Frankfurt, Germany

    Ruxandra Enzensberger

  7. Zentrum für Innere Medizin, Klinikum Schwäbisch Gmünd/Stauferklinik, Wetzgauer Str. 85, 73557, Mutlangen, Germany

    Holger Hebart

  8. Schwerpunkt Infektiologie, Medizinische Klinik und Poliklinik II, Universitätsklinikum Würzburg, Josef-Schneider-Straße 2, 97080, Würzburg, Germany

    Werner Heinz

  9. Abt. Hämatologie und Onkologie. Klinik und Poliklinik für Innere Medizin, Universität Rostock, Ernst-Heydemann-Str. 6, 18057, Rostock, Germany

    Christian Junghanss

  10. Abt. Hämatologie/Onkologie, St. Klinikum München-Neuperlach, Oskar-Maria-Graf-Ring 51, 81737, München, Germany

    Meinolf Karthaus

  11. Medizinische Klinik C, Ernst-Moritz-Arndt-Universität, Ferdinand-Sauerbruch-Str., 17487, Greifswald, Germany

    William Krüger

  12. Medizinische Klinik A, Medizinische Universitätsklinik, Albert-Schweitzer-Str. 33, 48149, Münster, Germany

    Utz Krug

  13. Hämatologie/Onkologie, Klinikum Traunstein, Cuno-Niggl-Straße 3, 83278, Traunstein, Germany

    Thomas Kubin

  14. Klinik für Hämatologie und Onkologie, Charité, Campus Benjamin Franklin, Hindenburgdamm 30, 12200, Berlin, Germany

    Olaf Penack

  15. Hämatologisch-Onkologische Gemeinschaftspraxis Dr. Reichert/Dr. Janssen, Kuhlenstraße 53d, 26655, Westerstede, Germany

    Dietmar Reichert

  16. Klinik für Gastroenterologie, Hepatologie und Infektiologie, Universitätsklinikum Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany

    Stefan Reuter

  17. Innere Medizin A, Med. Universitätsklinik, Albert-Schweitzer-Str. 33, 48149, Münster, Germany

    Gerda Silling

  18. II. Medizinische Klinik, Klinikum Passau, Innstraße 76, 94032, Passau, Germany

    Thomas Südhoff

  19. 3. Medizinische Abteilung, Johannes Gutenberg-Universität, Langenbeckstr. 1, 55131, Mainz, Germany

    Andrew J. Ullmann

  20. Medizinische Klinik, Hämatologie und Onkologie, Klinikum Ernst von Bergmann, Charlottenstraße 72, 14467, Potsdam, Germany

    Georg Maschmeyer

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  1. Angelika Böhme
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  2. Markus Ruhnke
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  3. Dieter Buchheidt
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  19. Andrew J. Ullmann
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  20. Georg Maschmeyer
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Correspondence to Angelika Böhme.

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Böhme, A., Ruhnke, M., Buchheidt, D. et al. Treatment of invasive fungal infections in cancer patients—Recommendations of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Oncology (DGHO). Ann Hematol 88, 97–110 (2009). https://doi.org/10.1007/s00277-008-0622-5

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