Corrado Girmenia1, Antonietta Ferretti, Walter Barberi. 1. Dipartimento di Ematologia, Oncologia, Anatomia Patologica e Medicina Rigenerativa, Azienda Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
Abstract
PURPOSE OF REVIEW: Knowledge of the epidemiology and the risk factors of invasive fungal diseases (IFDs) in hematopoietic stem cell transplant (HSCT) recipients is a critical determinant of the prevention, diagnosis and therapeutic antifungal strategy. Transplant procedures are characterized by a continuous evolution; therefore, an update of the epidemiological findings of IFDs in HSCT populations is needed. RECENT FINDINGS: In the last few years, the incidence and the clinical risk factors of IFD, mainly in allogeneic HSCT populations, have been investigated in prospective, multicenter studies. New findings in the different types and phases of transplant may be considered for a redefinition of the level of risk of IFD after HSCT. Furthermore, recent studies have uncovered associations between host's and/or donor's genetic variants and immunological risk for IFDs, in particular invasive aspergillosis. SUMMARY: Evolution of the transplant procedures was followed by an important change in the epidemiology and clinical risk of IFD after allogeneic HSCT. A new stratification of subpopulations according to different clinical infectious risk and genetic susceptibility may be considered to predict those patients most vulnerable to IFD and update tailored antifungal strategies.
PURPOSE OF REVIEW: Knowledge of the epidemiology and the risk factors of invasive fungal diseases (IFDs) in hematopoietic stem cell transplant (HSCT) recipients is a critical determinant of the prevention, diagnosis and therapeutic antifungal strategy. Transplant procedures are characterized by a continuous evolution; therefore, an update of the epidemiological findings of IFDs in HSCT populations is needed. RECENT FINDINGS: In the last few years, the incidence and the clinical risk factors of IFD, mainly in allogeneic HSCT populations, have been investigated in prospective, multicenter studies. New findings in the different types and phases of transplant may be considered for a redefinition of the level of risk of IFD after HSCT. Furthermore, recent studies have uncovered associations between host's and/or donor's genetic variants and immunological risk for IFDs, in particular invasive aspergillosis. SUMMARY: Evolution of the transplant procedures was followed by an important change in the epidemiology and clinical risk of IFD after allogeneic HSCT. A new stratification of subpopulations according to different clinical infectious risk and genetic susceptibility may be considered to predict those patients most vulnerable to IFD and update tailored antifungal strategies.