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Risk Stratification of Patients

Distribution of IFIs in patients with haematological malignancies1

Full preview Distribution of IFIs in patients with haematological malignancies

Adapted from Pagano et al, 20061

Risk stratification helps identify the patients likely to suffer from invasive aspergillosis, even if they do not present the classical risk factors, as defined in the guidelines or clinical trials2

During one of the largest epidemiology studies evaluating the incidence of IFIs in Europe, 92% (2,773/3,012) of patients with AML did not develop a mould infection1

Aspergillus species was the most common cause of mould infection1

Knowing which patients are at risk of developing invasive aspergillosis may aid early diagnosis and initiation of appropriate anti-fungal therapy1

 

Stratification of risk factors for IA requires distinction between different risk factors affecting the primary host condition2

Full preview Distinction between different risk factors affecting the primary host condition

Adapted from Herbrecht et al, 20122

  • Consideration needs to be given to:2
    • multiplicity of risk factors
    • synergy between different risk factors
       
  • Correct identification of the main risk factors for developing an IFD is essential in the evaluation of immunocompromised patients – and allows timely institution of appropriate antifungal therapy3

ALL, acute lymphoblastic leukaemia; AML, acute myeloid leukaemia; CLL, chronic lymphoblastic leukaemia; CML, chronic myeloid leukaemia; NHL, Non-Hodgkin lymphoma; HD, Hodgkin Disease; MM, multiple myeloma; IA, invasive aspergillosis; IFD, invasive fungal disease; IFI, invasive fungal infection; GvHD, graft versus host disease; HEPA, high-efficiency particulate air; HSCT, haematopoietic stem cell transplant; IA, invasive aspergillosis; ROS, reactive oxygen species;

References

  1. Pagano L, et al. Haematological. 2006; 91: 1068–75.
  2. Herbrecht R, et al. Ann N Y Acad Sci. 2012; 1272: 23–30.
  3. Pagano L, et al. J Antimicrob Chemother. 2011; 66(Suppl 1): i5–14.