Antifungal Treatment Strategy in Hematological Patients

• Published in: Nihon Ishinkin Gakkai Zasshi Vol. 63; no. 3; pp. 67 - 74
• Main Author: Kimura, Shun-ichi
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Society for Medical Mycology 2022; 一般社団法人 日本医真菌学会
• Subjects: acute leukemia; antifungal agent; hematopoietic cell transplantation; invasive aspergillosis; invasive candidiasis; invasive fungal infection; 侵襲性アスペルギルス症; 侵襲性カンジダ症; 侵襲性真菌感染症; 急性白血病; 抗真菌薬; 造血細胞移植
• ISSN: 2434-5229; 2434-5237
• DOI: 10.11534/ishinkin.22.007

Invasive fungal disease is one of the leading causes of morbidity and mortality in hematological patients undergoing intensive chemotherapy or hematopoietic cell transplantation. Novel antifungal agents and diagnostic methods including imaging and use of fungal biomarkers have broadened the treatment options for invasive fungal disease. At the same time, proper use of antifungal agents has become an important issue considering the high rates of adverse drug reactions, significant drug-drug interactions, and the emergence of antifungal resistance. Optimal strategies using antifungal prophylaxis, empirical or preemptive/diagnostic-driven antifungal therapy, and targeted therapy are essential in high-risk patients. A multidisciplinary approach involving doctors, pharmacists, nurses, and laboratory technicians will lead to better practices in the management of invasive fungal disease.