Prophylaxis and treatment of fungal infections associated with haematological malignancies

Patients with haematological malignancies form one of the most susceptible host groups for microbial infection, especially during neutropenia. The inc idence of invasive fungal infections has increased in recent years, highlig hting the need for better diagnosis and more effective antifungal therapies . Amphotericin B is the drug of choice for many fungal infections, although toxicity and the need for intravenous infusion restrict its use. When poss ible, oral administration of antifungal agents is preferable but intravenou s administration is often needed and current oral agents have their limitat ions: fluconazole because of a narrow spectrum of activity; itraconazole ca psules because of erratic absorption. In this review, prophylactic and trea tment options for systemic fungal infections are discussed. The specific ne eds of patients with different types of leukaemia and the benefits of new a mphotericin B and itraconazole formulations are examined. (C) 2000 Elsevier Science B.V. and International Society of Chemotherapy. All rights reserve d.