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Invasive Pulmonary Aspergillosis treatment duration in haematology patients in Europe: an EFISG, IDWP‐EBMT, EORTC‐IDG, SEIFEM survey

F. Lanternier 1, 2 D Seidel 3, 4 L. Pagano 5, 6 J Styczynski 7 M Mikulska 8 C. Pulcini 9, 10 J. Maertens 11 P Munoz 12 C Garcia 13 B. Rijnders 14 Mc Arendrup 15, 16, 17 R Sabino 18 C Verissimo 18 P Gaustad 19 N. Klimko S Arikan‐akdagli V Arsic 20 A Barac 20 A. Skiada 21 L Klingspor 22 R. Herbrecht 23 P Donnelly 24 Oa Cornely 25 C Lass‐flörl 26 O. Lortholary 1, 2
Abstract : Background : Invasive pulmonary aspergillosis (IPA) optimal duration of antifungal treatment is not known. Objectives : In a joint effort, four international scientific societies/groups performed a survey to capture current practices in European hematology centers regarding management of IPA. Methods : We conducted in 2017 a cross‐sectional internet‐based questionnaire survey to assess practices in sixteen European countries concerning IPA management in hematology patients including tools to evaluate treatment response, duration and discontinuation. The four groups/societies European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Fungal Infection Study Group (EFISG), Infectious Diseases Working Party‐European Society for Blood and Bone Marrow Transplantation (IDWP‐EBMT), European Organisation for Research and Treatment‐Infectious Disease group (EORTC‐IDG) and Sorveglianza Epidemiologica Infezioni nelle Emopatie (SEIFEM) were involved in the project. Results : 112 physicians from 14/16 countries answered the survey. Galactomannan antigen was available in serum and bronchoalveolar lavage in most centers (106/112 (95%) and 97/112 (87%) respectively), quantitative Aspergillus spp. PCR in 27/112 (24%) centres, β‐D‐glucan in 24/112 (21%) and positron emission tomography in 50/112 (45%). Treatment duration differed between haematological malignancies, with a median duration of 6 weeks [IQR 3‐12] for patients with AML, 11 [4‐12] for patients with allogenic stem cell transplantation and GvHD and 6 [3‐12] for patients with lymphoproliferative disease. Treatment duration significantly differed according to country. Conclusion : Essential IPA biomarkers are not available in all European countries and treatment duration is highly variable according to country. It will be important to provide guidelines to help with IPA treatment cessation with algorithms according to biomarkers availability.
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https://hal.univ-lorraine.fr/hal-02474197
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Submitted on : Tuesday, February 11, 2020 - 11:16:58 AM
Last modification on : Saturday, March 28, 2020 - 1:55:39 AM

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F. Lanternier, D Seidel, L. Pagano, J Styczynski, M Mikulska, et al.. Invasive Pulmonary Aspergillosis treatment duration in haematology patients in Europe: an EFISG, IDWP‐EBMT, EORTC‐IDG, SEIFEM survey. Mycoses, Wiley, 2020, ⟨10.1111/myc.13056⟩. ⟨hal-02474197⟩

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