Treatment and prophylaxis of invasive pulmonary fungal infections in hematologic malignancy and hematopoietic stem cell transplant recipients

Invasive fungal infections are the important causes of the morbidity and mortality in hematologic malignancy and hematopoietic stem cell transplant patients. Various fungal species cause pulmonary fungal infections in hematologic cancer. Frequently isolated fungal pathogens are Aspergillus, Zygomycetes ve Fusarium species. Amphotericin B has been used in the treatment of invasive aspergillosis for 30 years. Nowadays, according to the developments in the antifungal agents, voriconazole is the recommended drug for the treatment of invasive aspergillosis. Poor prognosis of invasive aspergillosis in the immunocompromised patients and low treatment response rates lead to the usage of antifungal combinations. As there is limited clinical data, antifungal combination therapies are used for unresponsive cases. Antifungal prophylaxis is considered in patients who are undergoing chemotherapy for acute leukemia and hematopoietic stem cell transplantation and posaconazole usage is under investigation.