Developments in identifying and managing mucormycosis in hematologic cancer patients.

Abstract

INTRODUCTION:

Mucormycoses represent a rare but very aggressive class of mold infections occurring in patients with hematological malignancies (HMs). In the past, patients at high risk of invasive mucomycosis (IM) were those affected by acute myeloid leukemia but over the last ten years the prophylaxis with a very effective mold-active drug, such as posaconazole, has completely modified the epidemiology. In fact, IM is now observed more frequently in patients with lymphoproliferative disorders who do not receive antifungal prophylaxis.

AREAS COVERED:

The attention was focused on the epidemiology, diagnosis, prophylaxis and treatment of IM in HMs. Authors excluded pediatric patients considering the different epidemiology and differences in treatment given the limitation of the use of azoles in the pediatric field. A systematic literature review was performed using PubMed database listings between February 2014 and February 2020 using the following MeSH terms: leukemia, hematological malignancies, stem cell transplantation, mucormycosis, molds, prophilaxis, treatment.

EXPERT OPINION:

The epidemiology of mucormycosis in HMs is changing in the last years. The availability of drugs more effective than in the past against this infection has reduced the mortality; however, a timely diagnosis remains a relevant problem potentially influencing the outcome of hematologic patients with IM.

• Authors: Livio Pagano, Giulia Dragonetti, Elena De Carolis, Giuseppe Veltri, Maria Ilaria Del Principe, Alessandro Busca
• Journal: Expert review of hematology (Expert Rev Hematol) Vol. 13 Issue 8 Pg. 895-905 (08 2020) ISSN: 1747-4094 [Electronic] England
• PMID: 32664759 (Publication Type: Journal Article, Meta-Analysis, Review)

Topics

• Clinical Decision-Making
• Combined Modality Therapy
• Diagnostic Imaging
• Disease Management
• Disease Susceptibility
• Hematologic Neoplasms (complications, epidemiology)
• Humans
• Incidence
• Mucormycosis (diagnosis, epidemiology, etiology, therapy)
• Outcome Assessment, Health Care
• Pre-Exposure Prophylaxis
• Prognosis
• Retreatment