Aspergillosis in hematopoietic stem cell transplant recipients: Risk factors, prophylaxis, and treatment

Research output: Contribution to journalReview articlepeer-review

Abstract

This article discusses newer antifungal agents, recent randomized controlled trials, and the 2008 guidelines for treatment of aspergillosis in reference to hematopoietic stem cell transplantation (HSCT). Strategies such as reduced-intensity conditioning and agents such as infliximab shed new light on aspergillosis risk. The association between Toll-like receptor polymorphisms and aspergillosis is an exciting development. Posaconazole was evaluated in two randomized prophylaxis trials, and a large, randomized trial established voriconazole's therapeutic superiority to amphotericin. However, many questions remain regarding which patients benefit most from prophylaxis; resistance to newer antifungals; and combination, salvage, and immunomodulatory therapies. Current therapies and strategies have improved the outlook of HSCT recipients with invasive aspergillosis. Future directions include increasingly sophisticated risk stratification, clinical testing of combination therapies, and adjunctive immunomodulatory therapies.

Original languageEnglish (US)
Pages (from-to)223-228
Number of pages6
JournalCurrent Infectious Disease Reports
Volume11
Issue number3
DOIs
StatePublished - May 1 2009
Externally publishedYes

ASJC Scopus subject areas

  • Infectious Diseases

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