Diagnosis and antimicrobial therapy of lung infiltrates in febrile neutropenic patients (allogeneic SCT excluded): updated guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO)

Maschmeyer, Georg; Carratalà, Jordi; Buchheidt, Dieter; Hamprecht, Axel; Heußel, Claus Peter; Kahl, Christoph; Lorenz, Joachim; Neumann, Silke; Rieger, Christina; Ruhnke, Markus; Salwender, Hans-Jürgen; Schmidt‐Hieber, Martin; Azoulay, Élie

doi:10.1093/annonc/mdu192

Cited by 126 publications

(107 citation statements)

References 171 publications

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“…It is common that there is a lack of high-quality microbiology data in these patients, for example, cultures or histology, and diagnosis of 'possible' IA is based on radiology and clinical aspects. 18 This leads to a possible bias, because we are unable to verify that some of the patients in the 'no IA group' had possible IA. Another effect of the lack of highquality microbiology data is the difficulty in distinguishing IA from other invasive mold infections.…”

Section: Discussionmentioning

confidence: 93%

Influence of pre-existing invasive aspergillosis on allo-HSCT outcome: a retrospective EBMT analysis by the Infectious Diseases and Acute Leukemia Working Parties

Penack

Tridello²,

Hoek

et al. 2015

Bone Marrow Transplant

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Historically, invasive aspergillosis (IA) has been a major barrier for allogeneic hematopoietic stem cell transplantation (allo-HSCT). The influence of invasive IA on long-term survival and on transplant-related complications has not been investigated in a larger patient cohort under current conditions. Our aim was to analyze the long-term outcome of patients undergoing allo-HSCT with a history of prior IA. We used European Society for Blood and Marrow Transplantation database data of first allo-HSCTs performed between 2005 and 2010 in patients with acute leukemia. One thousand one hundred and fifty patients with data on IA before allo-HSCT were included in the analysis. The median follow-up time was 52.1 months. We found no significant impact of IA on major transplant outcome variables such as overall survival, relapse-free survival, non-relapse mortality, cumulative incidence of acute GvHD grade II-IV, chronic GvHD, pulmonary complications and leukemia relapse. However, we found a trend toward lower overall survival (P = 0.078, hazard ratio (HR) (95% confidence interval (CI)): 1.16 (0.98, 1.36)) and higher non-relapse mortality (P = 0.150, HR (95% CI): 1.19 (0.94, 1.50)) in allo-HSCT recipients with pre-existing IA. Our data suggest that a history of IA should not generally be a contraindication when considering the performance of allo-HSCT in patients with acute leukemia.

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Section: Discussionmentioning

confidence: 93%

Influence of pre-existing invasive aspergillosis on allo-HSCT outcome: a retrospective EBMT analysis by the Infectious Diseases and Acute Leukemia Working Parties

Penack

Tridello²,

Hoek

et al. 2015

Bone Marrow Transplant

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“…Hence, this microbiological finding does not justify the addition of a glycopeptide. Similarly, enterococci or yeasts isolated from broncho-alveolar lavage fluid are typically not causative for a respiratory tract infection [14] and should, therefore, not lead to a change of therapy. This highlights the necessity of a rational diagnostic strategy guided by presenting symptoms and interpreted correctly as opposed to taking swabs from multiple body sites including those without clinical abnormalities and (mis-)using abnormal laboratory results as triggers for starting (or changing) systemic broad-spectrum antimicrobial therapy.…”

Section: Bacterial Infections - Antibiotic Stewardshipmentioning

confidence: 99%

Challenges in Infectious Diseases for Haematologists

Lilienfeld‐Toal

Maschmeyer

2018

Oncol Res Treat

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Infections remain a threat for patients with haematological malignancies. In accordance with the European Hematology Association roadmap we provide a concise overview regarding the most relevant current challenges in infectious diseases for haematologists. These include bacterial infections and the need for antibiotic stewardship as well as infections with community-acquired respiratory viruses, infections in patients receiving targeted therapies, re-activations of latent infections and vaccination strategies. The following review intends to summarise the most relevant information for clinicians currently caring for patients with haematological malignancies. Recommendations given are based on the guidelines published by the Infectious Diseases Working Party of the German Society of Haematology and Medical Oncology.

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“…The impact of bone marrow stem cell transplantation was also highlighted. Diagnostic workup for lung infiltrates in patients with cancer was nicely summarized in the editorial from Rieger [4] along the lines of the recently published guidelines [5]. The corresponding approach for suspected or documented invasive aspergillosis in ICU patients has also been published [6].…”

Section: Severe Infectionsmentioning

confidence: 99%