Originally published as JCO Early Release 10.1200/JCO.2008.20.1178 on June 1 2009

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Approaches to the Management of Invasive Fungal Infections in Hematologic Malignancy and Hematopoietic Cell Transplantation

From the Department of Hematology, Edouard Herriot Hospital, Place d'Arsonval, Lyon, France; and Division of Infectious Diseases, City of Hope, Duarte, CA.

Corresponding author: James I. Ito, MD, Division of Infectious Diseases, City of Hope, 1500 E. Duarte Rd, Duarte, CA 91010-3000; e-mail: jito{at}coh.org.

Patients with hematologic malignancy and hematopoietic cell transplant (HCT) recipients are at increased risk for invasive fungal infection (IFI) as a result of immunosuppression or organ damage stemming from their underlying disease, its treatment, or both. Such IFIs can cause significant morbidity and mortality, and the diagnosis and treatment of infected patients frequently are clinically challenging. This article discusses the epidemiology and risk factors for IFI in patients with hematologic malignancy and HCT recipients. The pros and cons of available antifungal agents are discussed, and evolving treatment strategies and recent prophylaxis guidelines from various professional organizations are reviewed. Finally, recommendations are offered for antifungal prophylaxis according to risk group.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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