恶性血液病患者中侵袭性真菌病的二级预防  

Secondary Antifungal Prophylaxis in Hematological Malignancy Patients with Previous Invasive Fungal Disease——Review

作　　者：刘明娟[1,2] 黄文荣[1] 于力[1] 

机构地区：[1]中国人民解放军总医院血液科,北京100853 [2]解放军第309医院血液科,北京100091

出　　处：《中国实验血液学杂志》2015年第2期596-600,共5页Journal of Experimental Hematology

基　　金：国家自然科学基金(81470010);首都市民健康项目培育(Z111107067311070);解放军301医院技术创新苗圃基金(13KMM01)

摘　　要：侵袭性真菌病在恶性血液病患者中发病率及死亡率均很高,有真菌感染病史的患者在进一步的化疗或造血干细胞移植中真菌感染复燃率高、预后差。真菌的二级预防可有效地预防真菌感染复燃。给予有效的二级预防,既往侵袭性真菌感染病史不影响化疗继续进行,也不再是异基因造血干细胞移植的绝对禁忌症。已经证明广谱抗真菌药物如伏立康唑、伊曲康唑、两性霉素B、卡泊芬净作为二级预防药物取得了很好的疗效,但在粒细胞缺乏和免疫抑制状态下预防真菌感染复燃仍然面临巨大的挑战。本文就恶性血液病患者中二级抗真菌预防的现状作一综述。Invasive fungal disease （IFD） causes a high morbidity and mortality in patients with hematological malignancies. Reactivation of IFD after chemotherapy or hematopoietic stem cell transplantation （HSCT） is very common and associated with poor prognosis. Secondary antifungal prophylaxis （SAP） is effective in preventing IFD recurrence. With effective SAP, a history of IFD is not an absolute contraindication to allogeneic HSCT or continuation of high-dose chemotherapy. In recent years, a variety of antifungal drugs such as voriconazole, itraconazole, AraB and caspofungin have been found to be effective for SAP. However, its management during granulocytopenia and immunosuppress mains challenging. This review summarizes the current status of SAP in patients with hematological malignancies

关 键 词：侵袭性真菌病 恶性血液病 二级预防 

分 类 号：R733[医药卫生—肿瘤]