Fungal infections in hematopoietic stem-cell transplant patients: a review of epidemiology, diagnosis, and management
The advent of bone marrow transplant has opened doors to a different approach and offered a new treatment modality for various hematopoietic stem-cell-related disorders. Since the first bone marrow transplant in 1957, there has been significant progress in managing patients who undergo bone marrow t...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2021-08-01
|
| Series: | Therapeutic Advances in Infectious Disease |
| Online Access: | https://doi.org/10.1177/20499361211039050 |
| _version_ | 1818908387182641152 |
|---|---|
| author | Mandeep Singh Rahi Vishal Jindal Prachi Pednekar Jay Parekh Kulothungan Gunasekaran Sorabh Sharma Michael Stender Ishmael A. Jaiyesimi |
| author_facet | Mandeep Singh Rahi Vishal Jindal Prachi Pednekar Jay Parekh Kulothungan Gunasekaran Sorabh Sharma Michael Stender Ishmael A. Jaiyesimi |
| author_sort | Mandeep Singh Rahi |
| collection | DOAJ |
| description | The advent of bone marrow transplant has opened doors to a different approach and offered a new treatment modality for various hematopoietic stem-cell-related disorders. Since the first bone marrow transplant in 1957, there has been significant progress in managing patients who undergo bone marrow transplants. Plasma-cell disorders, lymphoproliferative disorders, and myelodysplastic syndrome are the most common indications for hematopoietic stem-cell transplant. Despite the advances, invasive fungal infections remain a significant cause of morbidity and mortality in this high-risk population. The overall incidence of invasive fungal infection in patients with hematopoietic stem-cell transplant is around 4%, but the mortality in patients with allogeneic stem-cell transplant is as high as 13% in one study. Type of stem-cell transplant, conditioning regimen, and development of graft- versus -host disease are some of the risk factors that impact the risk and outcomes in patients with invasive fungal infections. Aspergillus and candida remain the two most common organisms causing invasive fungal infections. Molecular diagnostic methods have replaced some traditional methods due to their simplicity of use and rapid turnaround time. Primary prophylaxis has undoubtedly shown to improve outcomes even though breakthrough infection rates remain high. The directed treatment has seen a significant shift from amphotericin B to itraconazole, voriconazole, and echinocandins, which have shown better efficacy and fewer adverse effects. In this comprehensive review, we aim to detail epidemiology, risk factors, diagnosis, and management, including prophylaxis, empiric and directed management of invasive fungal infections in patients with hematopoietic stem-cell transplant. |
| first_indexed | 2024-12-19T22:10:12Z |
| format | Article |
| id | doaj.art-f8c7acef53cb4cab9cb026a69feda6b8 |
| institution | Directory Open Access Journal |
| issn | 2049-937X |
| language | English |
| last_indexed | 2024-12-19T22:10:12Z |
| publishDate | 2021-08-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Infectious Disease |
| spelling | doaj.art-f8c7acef53cb4cab9cb026a69feda6b82022-12-21T20:03:56ZengSAGE PublishingTherapeutic Advances in Infectious Disease2049-937X2021-08-01810.1177/20499361211039050Fungal infections in hematopoietic stem-cell transplant patients: a review of epidemiology, diagnosis, and managementMandeep Singh RahiVishal JindalPrachi PednekarJay ParekhKulothungan GunasekaranSorabh SharmaMichael StenderIshmael A. JaiyesimiThe advent of bone marrow transplant has opened doors to a different approach and offered a new treatment modality for various hematopoietic stem-cell-related disorders. Since the first bone marrow transplant in 1957, there has been significant progress in managing patients who undergo bone marrow transplants. Plasma-cell disorders, lymphoproliferative disorders, and myelodysplastic syndrome are the most common indications for hematopoietic stem-cell transplant. Despite the advances, invasive fungal infections remain a significant cause of morbidity and mortality in this high-risk population. The overall incidence of invasive fungal infection in patients with hematopoietic stem-cell transplant is around 4%, but the mortality in patients with allogeneic stem-cell transplant is as high as 13% in one study. Type of stem-cell transplant, conditioning regimen, and development of graft- versus -host disease are some of the risk factors that impact the risk and outcomes in patients with invasive fungal infections. Aspergillus and candida remain the two most common organisms causing invasive fungal infections. Molecular diagnostic methods have replaced some traditional methods due to their simplicity of use and rapid turnaround time. Primary prophylaxis has undoubtedly shown to improve outcomes even though breakthrough infection rates remain high. The directed treatment has seen a significant shift from amphotericin B to itraconazole, voriconazole, and echinocandins, which have shown better efficacy and fewer adverse effects. In this comprehensive review, we aim to detail epidemiology, risk factors, diagnosis, and management, including prophylaxis, empiric and directed management of invasive fungal infections in patients with hematopoietic stem-cell transplant.https://doi.org/10.1177/20499361211039050 |
| spellingShingle | Mandeep Singh Rahi Vishal Jindal Prachi Pednekar Jay Parekh Kulothungan Gunasekaran Sorabh Sharma Michael Stender Ishmael A. Jaiyesimi Fungal infections in hematopoietic stem-cell transplant patients: a review of epidemiology, diagnosis, and management Therapeutic Advances in Infectious Disease |
| title | Fungal infections in hematopoietic stem-cell transplant patients: a review of epidemiology, diagnosis, and management |
| title_full | Fungal infections in hematopoietic stem-cell transplant patients: a review of epidemiology, diagnosis, and management |
| title_fullStr | Fungal infections in hematopoietic stem-cell transplant patients: a review of epidemiology, diagnosis, and management |
| title_full_unstemmed | Fungal infections in hematopoietic stem-cell transplant patients: a review of epidemiology, diagnosis, and management |
| title_short | Fungal infections in hematopoietic stem-cell transplant patients: a review of epidemiology, diagnosis, and management |
| title_sort | fungal infections in hematopoietic stem cell transplant patients a review of epidemiology diagnosis and management |
| url | https://doi.org/10.1177/20499361211039050 |
| work_keys_str_mv | AT mandeepsinghrahi fungalinfectionsinhematopoieticstemcelltransplantpatientsareviewofepidemiologydiagnosisandmanagement AT vishaljindal fungalinfectionsinhematopoieticstemcelltransplantpatientsareviewofepidemiologydiagnosisandmanagement AT prachipednekar fungalinfectionsinhematopoieticstemcelltransplantpatientsareviewofepidemiologydiagnosisandmanagement AT jayparekh fungalinfectionsinhematopoieticstemcelltransplantpatientsareviewofepidemiologydiagnosisandmanagement AT kulothungangunasekaran fungalinfectionsinhematopoieticstemcelltransplantpatientsareviewofepidemiologydiagnosisandmanagement AT sorabhsharma fungalinfectionsinhematopoieticstemcelltransplantpatientsareviewofepidemiologydiagnosisandmanagement AT michaelstender fungalinfectionsinhematopoieticstemcelltransplantpatientsareviewofepidemiologydiagnosisandmanagement AT ishmaelajaiyesimi fungalinfectionsinhematopoieticstemcelltransplantpatientsareviewofepidemiologydiagnosisandmanagement |