Immunotherapy for invasive mold disease in severely immunosuppressed patients.

Safdar A.

Clin Infect Dis. 2013 Jul;57(1):94-100.

Response to systemic antifungal therapy alone remains disproportionately less
satisfactory in immunosuppressed transplant and oncology patients. As insight in
fungal immunopathogenesis forges ahead, interventions for boosting immune
functions along with antimicrobial drugs has shown promise in preclinical
experiments. The clinical experience with immunotherapy for invasive mold disease
is limited. Most studies have involved small numbers of patients at a single
institution or data collected retrospectively. An overview of various facts of
immune modulatory drug intervention is presented, including major considerations
in antifungal immunotherapy in immunosuppressed patients. Patients in whom
immunotherapy is being considered must be critically evaluated to identify the
underlying immune defects, including treatment-induced immunosuppression.
Antifungal immunotherapy is appealing; however, before routine clinical use is
recommended, well-designed prospective comparative clinical trials are urgently
needed.