Tratamiento antifúngico empírico: una alternativa válida para la infección fúngica invasora RESUMEN

117 Rev Esp Quimioter 2011;24(3):117-122 Fungal infections have very serious implications and are most likely to affect patients with a hematological malignancy. Hematological malignancy patients frequently develop invasive fungal infection (IFI) caused by filamentous fungi and may be considered as subjects to the risk prototype. The intensity and duration of neutropenia, the diagnosis of acute leukemia, and the severe impairment of lymphocytic activity are classic predisposing factors for IFI, and are the basis for risk stratification into high, intermediate and low risk groups. High-risk criteria include profound (absolute neutrophil count < 100/mm) and prolonged (> 14 days) neutropenia after induction or rescue chemotherapy of the acute leukemias or in the context of immunodeficiency secondary to graft-versus-host disease (GVHD) after allogenic stem cell transplantation (SCT) and its treatment (corticosteroids, anti-TNF-α antibodies, alemtuzumab or anti-thymocyte globulin –ATG-) or to a cytomegalovirus infection. In the medium-risk group are included the neutropenia of 7-14 days or after consolidation or intensification chemotherapy of patiens undergoing acute leukemia. The lowrisk category is characterized by neutropenia of < 7 days or during autologous SCT.