Primary Prophylaxis of Invasive Fungal Diseases in Allogeneic Stem Cell Transplantation: Revised Recommendations from a Consensus Process by Gruppo Italiano Trapianto Midollo Osseo (GITMO) |
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| Affiliation: | 1. Department of Hematology, Azienda Policlinico Umberto I, Sapienza University of Rome, Rome, Italy;2. Center for Q1 the Study of Myelofibrosis, IRCCS Fondazione Policlinico S. Matteo, University of Pavia, Pavia, Italy;3. GIMEMA Foundation, Rome, Italy;4. Stem Cell Transplant Unit, Fondazione Policlinico Tor Vergata, Tor Vergata University, Rome, Italy;5. Hematology and Bone Marrow Transplant Center, Ospedale Maggiore, Parma, Italy;6. Division of Hematology II, IRCCS S. Martino University Hospital e IST, Genoa, Italy;7. Institute of Hematology and Medical Oncology, L. e A Seragnoli, Policlinico S.Orsola Malpigli, Bologna, Italy;8. Department of Hematology, A.O. di Careggi, University of Florence, Florence, Italy;9. Department of Oncology and Hematology, A.O. Citta'' della Salute e della Scienza di Torino, P.O. Molinette, Torino, Italy;10. Division of Infectious Diseases and Bone Marrow Transplant Unit, Giannina Gaslini Institute, Genoa, Italy;11. AOU Meyer Children Hospital Medical Direction, Florence, Italy;12. Pediatric Onco-hematology Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy;13. Hematology and Bone Marrow Transplant Unit, San Raffaele Hospital, Milan, Italy;14. Pediatrics and Pediatric Hematology Unit, Az. Osp. S.Camillo-Forlanini, Rome, Italy;15. Onco-hematology Unit, Ospedale Pediatrico Bambino Gesù, Rome, Italy;16. Department of Infectious Diseases, IRCCS S. Martino University Hospital e IST, Genoa, Italy;17. Institute of Hematology, Policlinic A. Gemelli, Sacred Heath Catholic University, Rome, Italy;18. Oncology, Hematology and Hematopoietic Stem Cell Transplant Program, U.O. Pediatrics-Prof. Pession, S. Orsola-Malpighi, University of Bologna, Bologna, Italy;19. Division of Hematology, Azienda Ospedaliera Giovanni XXIII, Bergamo, Italy |
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| Abstract: | This document updates and expands the recommendations on primary prophylaxis of invasive fungal diseases (IFD) in allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients, published in 2009 by the Gruppo Italiano Trapianto Midollo Osseo (GITMO). A consensus process was undertaken to describe and evaluate current information and practice regarding risk stratification and primary antifungal prophylaxis during the pre-engraftment and postengraftment phases after allo-HSCT. The revised recommendations were based on the evaluation of recent literature including a large, prospective, multicenter epidemiological study of allo-HSCT recipients conducted among the GITMO transplantation centers during the period of 2008 to 2010. It is intended as a guide for the identification of types and phases of transplantation at low, standard, and high risk for IFD, according to the underlying disease, transplantation, and post-transplantation factors. The risk stratification was the critical determinant of the primary antifungal approach for allo-HSCT recipients. |
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| Keywords: | Allogeneic hematopoietic stem cell transplantation (HSCT) Fungal infections Antifungal prophylaxis Consensus |
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