Invasive fungal infections in the neutropenic cancer patient: Current approaches and future strategies

Invasive fungal infections are important causes of morbidity and mortality in cancer patients with prolonged neutropenia following dose-intensive chemotherapy or hematopoietic stem cell transplantation. Recent epidemiologic trends indicate a shift toward infections by Aspergillus species, non-albicans Candida species, and previously uncommon fungal pathogens that have decreased susceptibility to current antifungal agents. In the last decade, much progress has been made in establishing disease definitions and paradigms for antifungal intervention and in the design and conduct of interventional clinical trials. This article reviews current approaches to prevention and treatment of opportunistic fungal infections in neutropenic patients and discusses novel approaches to antifungal chemotherapy and supportive measures.