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    Home > Medical News > Latest Medical News > Preventive treatment significantly reduces the risk of invasive fungal infections

    Preventive treatment significantly reduces the risk of invasive fungal infections

    • Last Update: 2020-12-05
    • Source: Internet
    • Author: User
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    Invasive fungal disease (IFD) is an infectious disease in which fungi invade the body, grow, reproduce and cause inflammatory response and tissue damage in tissues, organs or blood, and in recent years, with the application of new treatments such as targeted therapy in the field of blood tumors, the risk of IFD increases. Based on some new research data and changes in IFD in recent years, the China Invasive Fungal Infection Working Group revised the diagnostic standards and treatment principles of IFD in China by reference to relevant guidelines such as Europe and the United States. On September 5, the Hematologist Branch of the Chinese Physicians Association officially released the Diagnostic Standards and Treatment Principles for Invasive Fungi Disease in Patients with Blood Diseases/Malignant Tumors (the 6th Revision) at the Annual Meeting of the Hematology Credit Association of the China Healthcare International Exchange Promotion Association and the First Huaxia Blood and Transplant Forum in Shenzhen.
    professor Wu Depei, director of the Blood Credit Association of the Chinese Medical Association
    and director of the hematology department of the First Hospital affiliated with Suzhou University, said that the domestic forward-looking multi-center epidemiological study (CAESAR study) showed that the total incidence of confirmed and clinically diagnosed IFD was 2.1% in patients with blood malignancies receiving chemotherapy.
    Professor Huang Xiaojun, director of the National Center for Clinical Medicine for Blood System Diseases and director of the Institute of Hematology at Peking University People's Hospital, said that in recent years, the application of targeted treatment of tumor molecules has led to an increased risk of IFD, and a foreign study showed that the incidence of IFD reached 7.1% in patients with relapsed/difficult-to-treat chronic lymphoblastic leukemia (CLL) treated with BTK inhibitors. Candide and asphalt are the most common pathogenic bacteria of IFD in patients with blood diseases, fungalemia is common to Candice, and IFD in the lungs is dominated by silky fungi, of which asmycin is the main pathogenic bacteria.
    Huang Xiaojun stressed that IFD is one of the most important causes of death from malignant tumors in the blood system. Foreign data show that although ifD-related disease death rate has been declining overall in the past 20 years, IFD-related death rate after hematopoietic stem cell transplantation is still as high as 50%. Domestic multi-center research data show that the total death rate of blood malignant diseases receiving chemotherapy is only 1.5%, but the death rate of IFD patients diagnosed and clinically diagnosed reached 11.7%.
    Wu Depei, the new version of the principles of diagnosis and treatment is still revised according to the strategies of preventive treatment, empirical treatment, diagnostic-driven treatment and targeted therapy, including primary prevention and re-prevention.
    primary prevention refers to patients with IFD high-risk factors, before the appearance of symptoms of infection pre-application of antifmicrobial drugs to prevent IFD occurrence. Studies suggest that people with an IFD incidence greater than 5% benefit from antifellar probiotic therapy, and those at high risk with an IFD incidence greater than 10% benefit significantly.
    research suggests that the high-risk and medium-risk antifellar prevention treatment of patients with malignant blood disease receiving chemotherapy benefits. Hematopoietic stem cell transplant patients receiving preventive treatment can significantly reduce IFD occurrence and systemic antifellar drug use. Therefore, the new version of the diagnosis and treatment principle recommended that patients with IFD high-risk factors, such as hematopoietic stem cell transplant patients, acute leukemia initial induction or rescue chemotherapy patients, etc., should receive antifellar preventive treatment.
    resusor prevention is the administration of antifilmic drugs to prevent IFD reocgeneration in patients with a history of confirmed or clinical diagnosis of IFD when IFD is fully or partially remissioned and then undergoing chemotherapy or hematopoietic stem cell transplantation. The course of preventive treatment depends mainly on the improvement of ifD high risk factors in patients, such as hematopoietic stem cell transplant patients generally cover at least 3 months after transplantation.
    Wu Depei also introduced that the giant cell virus is a herpes virus group DNA virus, widespread, difficult to prevent. Patients with solid organ or cell transplantation, patients with long-term heavy use of immunosuppressants such as glucosticoids, etc. are all high-risk groups for reactivation of cytokine virus, and complications related to cytokine virus are also one of the main causes of death in stem cell transplant patients.
    Wu Depei said that patients now have to eliminate or suppress cytocytovirus by various means before transplanting allogeneic stem cells. The cytocytovirus needs to be closely monitored and prevented within 1 year after transplantation, especially the first 100 days. Once a patient has symptoms, treatment against cytomemic cytovirus needs to be initiated immediately, and this clinical preemptional treatment effectively reduces the risk of death.
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