home journals A-Z subject areas advanced search ... Issue 6 Viewing options Abstract Full text PDF Related literature: Other articles by authors Wingard JR Leather HL Tools: E-mail to a friend Download references Opinion Diagnosis and Therapy of Invasive Aspergillosis in Hematopoietic Stem Cell Transplant Recipients John R Wingard MD and Helen L Leather BPharm BCPS Division of HematologyOncology, PO Box 100277, University of Florida Shands Cancer Center, Gainesville, FL, 32610, USA Current Treatment Options in Infectious Diseases Opinion statement Invasive aspergillosis is an increasing cause of infectious morbidity after hematopoi-etic stem cell transplantation (HSCT) and has a high case fatality rate. It is the main infectious challenge to HSCT clinicians. Reasons cited for poor treatment outcomes include difficulty in accurate diagnosis, which frequently results in late start of therapy, and therapies that are highly toxic or suboptimally effective. New diagnostics, including antigen assays such as galactomannan and beta glucan, and polymerase chain reaction assays offer hope that noninvasive means will make an early diagnosis in the course of infection. New therapies such as voriconazole for first- or second-line treatment, or caspofungin for second-line therapy, offer promise for less toxic and more efficacious therapies. Outline Introduction Opinion statement Introduction Treatment References Invasive aspergillosis is a major cause of morbidity and mortality after hematopoietic stem cell transplantation (HSCT). Two peaks of occurrence have been noted in observational studies. The first is before engraftment, during neutropenia. The second occurs later during the post-engraftment period, during corticosteroid use or occurrence of graft-versus-host disease (GVHD). | |
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