Epidemiology of invasive fungal infections in bone marrow transplantation. EORTC Invasive Fungal Infections Cooperative Group.

Infections and graft-versus-host disease are the major causes of morbidity and mortality in bone marrow transplantation (BMT). Bacterial infections can nowadays be treated effectively in most instances. The prophylactic and therapeutic armamentarium for viral infections is improving. Fungal infections on the contrary remain a major obstacle for successful outcome in the transplant situation. Invasive fungal infections are mainly caused by Candida and Aspergillus spp. and more seldom by Mucor, Trichosporon and Fusarium. Invasive fungal infections are notoriously difficult to diagnose early and effective non-toxic treatments are still out of reach. Prophylaxis for Candida albicans has become more effective with new triazoles but for species other than albicans and for Aspergillus spp. prophylaxis still remains a major problem. Better treatment modalities, more effective prophylaxis and better knowledge of risk factors are urgently needed. The recently created Invasive Fungal Infections Cooperative Group of the EORTC chaired by Professor F. Meunier runs different surveys to investigate the incidence and nature of invasive fungal infections in cancer patients and in BMT. The group runs different clinical trials on the prophylaxis and treatment of invasive fungal infections.