Evidence mapPaperPMID 37311136Full record

ReviewThe Journal of antimicrobial chemotherapy2023

Primary prophylaxis of invasive fungal diseases in patients with haematological malignancies: 2022 update of the recommendations of the Infectious Diseases Working Party (AGIHO) of the German Society for Haematology and Medical Oncology (DGHO).

Jannik Stemler, Sibylle C Mellinghoff, Yascha Khodamoradi, Rosanne Sprute, Annika Y Classen, Sonja E Zapke, Martin Hoenigl, Robert Krause, Martin Schmidt-Hieber, Werner J Heinz and 13 more

Open access · hybridAbstract readReview
In one paragraph

Review in The Journal of antimicrobial chemotherapy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
54citing papers in PubMed, 1 pooled it
15.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

54 citing papers in PubMed, 1 synthesis or guideline pooled it, 82 citations in OpenAlex.

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  12. Optimizing Treatment, Minimizing Risk: Therapeutic Drug Monitoring in Hematological Malignancies.Mediterranean journal of hematology and infectious diseases · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors at 16 institutions in 2 countries.

Jannik StemlerUniversity of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany.ORCID 0000-0001-9152-2469
Sibylle C MellinghoffUniversity of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany.ORCID 0000-0003-3928-2503
Yascha KhodamoradiDepartment of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany.ORCID 0000-0001-5972-0967
Rosanne SpruteUniversity of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany.ORCID 0000-0003-2457-6437
Annika Y ClassenUniversity of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany.ORCID 0000-0003-2905-5139
Sonja E ZapkeDepartment Hematology, Oncology, Infectious disease and Palliatve Care, Helios University Hospital Wuppertal, Wuppertal, Germany.
Martin HoeniglDivision of Infectious Diseases, Department of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Medical University of Graz, Graz, Austria and BioTechMed, Graz, Austria.ORCID 0000-0002-1653-2824
Robert KrauseDivision of Infectious Diseases, Department of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Medical University of Graz, Graz, Austria and BioTechMed, Graz, Austria.ORCID 0000-0001-6656-3648
Martin Schmidt-Hieber2nd Medical Clinic (Hematology, Oncology, Pneumology, Nephrology), Carl-Thiem Clinic Cottbus, Cottbus, Germany.ORCID 0000-0002-3071-6945
Werner J HeinzMedical Clinic II, Caritas Hospital, Bad Mergentheim, Germany.ORCID 0000-0002-7833-9202
Michael KleinDepartment of Hematology and Medical Oncology, Klinikum Vest, Knappschaftskrankenhaus, Recklinghausen, Germany.
Philipp KoehlerUniversity of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany.ORCID 0000-0002-7386-7495
Blasius LissDepartment Hematology, Oncology, Infectious disease and Palliatve Care, Helios University Hospital Wuppertal, Wuppertal, Germany.ORCID 0000-0002-3551-3450
Michael KoldehoffDepartment of Bone Marrow Transplantation, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.ORCID 0000-0002-8738-5884
Christoph BuhlMedical Clinic III, Hospital Leverkusen, Leverkusen.
Olaf PenackCharité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin, Germany.ORCID 0000-0003-4876-802X
Georg MaschmeyerFormerly Department of Hematology, Oncology and Palliative Care, Klinikum Ernst von Bergmann, Potsdam, Germany.ORCID 0000-0003-2378-2466
Enrico SchalkDepartment of Haematology and Oncology, Medical Centre, Otto-von-Guericke University Magdeburg, Magdeburg, Germany.ORCID 0000-0003-1892-5098
Cornelia Lass-FlörlInstitute of Hygiene and Medical Microbiology, ECMM Excellence Centre, Medical University of Innsbruck, Innsbruck, Austria.ORCID 0000-0002-2946-7785
Meinolf KarthausDepartment of Hematology, Oncology and Palliative Care, Klinikum Neuperlach, Munich, Germany.ORCID 0000-0002-0793-9729
Markus RuhnkeHelios Klinikum Aue, Klinik für Hämatologie/Onkologie & Palliativmedizin, Aue, Germany.
Oliver A CornelyUniversity of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Cologne, Germany.ORCID 0000-0001-9599-3137
Daniel TeschnerDepartment of Hematology, and Medical Oncology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.ORCID 0000-0001-7351-8060
University of Cologne · DEMedical University of Graz · ATCaritas-Krankenhaus Bad Mergentheim · DECarl-Thiem-Klinikum Cottbus · DEGoethe University Frankfurt · DEHelios Universitätsklinikum Wuppertal · DEHumboldt-Universität zu Berlin · DEInnsbruck Medical University · ATJohannes Gutenberg University Mainz · DEKlinikum Ernst von Bergmann · DEKlinikum Leverkusen · DEKlinikum Vest · DEMünchen Klinik Neuperlach · DEOtto-von-Guericke-Universität Magdeburg · DEUniversity of Duisburg-Essen · DEWitten/Herdecke University · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Patients with haematological malignancies (HM) are at high risk of developing invasive fungal disease (IFD) with high morbidity and attributable mortality. We reviewed data published until September 2021 to update the 2017 antifungal prophylaxis recommendations of the German Society of Haematology and Medical Oncology (DGHO). The strong recommendation to administer antifungal prophylaxis in patients with HM with long-lasting neutropenia, i.e. <500 cells/μL for >7 days remains unchanged. Posaconazole remains the drug of choice for mould-active prophylaxis in these patients. Novel treatment options in HM, such as CAR-T-cell treatment or novel targeted therapies for acute myeloid leukaemia (AML) were considered, however, data are insufficient to give general recommendations for routine antifungal prophylaxis in these patients. Major changes regarding specific recommendations compared to the 2017 edition are the now moderate instead of mild support for the recommendations of isavuconazole and voriconazole. Furthermore, published evidence on micafungin allows recommending it at moderate strength for its use in HM. For the first time we included recommendations for non-pharmaceutical measures regarding IFD, comprising the use of high-efficiency particulate air (HEPA) filters, smoking, measures during construction work and neutropenic diets. We reviewed the impact of antifungal prophylaxis with triazoles on drug-drug interactions with novel targeted therapies that are metabolized via cytochrome p450 where triazoles inhibit CYP3A4/5. The working group recommends reducing the dose of venetoclax when used concomitantly with strong CYP3A4 inhibiting antifungals. Furthermore, we reviewed data on the prophylactic use of novel antifungal agents. Currently there is no evidence to support their use in a prophylactic setting in clinical practice.

Indexed as

Communicable DiseasesHematologic NeoplasmsHematologyInvasive Fungal InfectionsAntifungal AgentsCytochrome P-450 CYP3AHumansMedical OncologyTriazolesAntifungal AgentsCytochrome P-450 CYP3ATriazoles

Identifiers

PMID37311136
PMCPMC10393896
OpenAlexW4380538131

What Socratic holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.