AI Article Synopsis
- Antifungal prophylaxis for patients with acute myelogenous leukemia (AML) is well-established, but risks and strategies for acute lymphocytic leukemia (ALL) patients are less understood.
- Recent studies suggest that ALL poses a significant risk for invasive fungal infections (IFIs), which raises concerns about effective prophylaxis.
- There are concerns about the safety of using azole antifungals due to their interactions with vincristine, a key chemotherapy drug in ALL, highlighting the need for further research into new antifungal options that are being developed.
Article Abstract
Although the benefit for any type of antifungal prophylaxis in patients with acute myelogenous leukaemia is well accepted, less is known about the risk for invasive fungal infections (IFIs) and the optimal prophylaxis strategies in patients with acute lymphocytic leukaemia (ALL). Based on recent studies, ALL is a disease that appears to be associated with significant risk for IFIs. The pharmacokinetic interactions between azoles and vincristine, an antineoplastic agent that is part of modern combination chemotherapies in ALL, results in clinically significant neurotoxicity that makes the use of azoles problematic. However, a number of questions regarding azole-vincristine interactions remain unanswered. In this viewpoint, we call for a renewed interest in antifungal prophylaxis studies in ALL in view of the availability of several non-azole novel antifungal agents that are under preclinical and/or clinical development. This is clearly a major unmet need in modern clinical mycology.
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| http://dx.doi.org/10.1111/myc.12786 | DOI Listing |
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