Razionale: With the introduction of effective antifungal prophylaxis the release of galactomannan may be impaired and radiological findings may be less pathognomonic increasing the chance of misdiagnosing IFIs and, therefore, leading to under treatment. Furthermore, the use of aggressive chemotherapies and new immunotherapies with immunomodulating agents in other categories of patients with HM (i.e. multiple myeloma, chronic lymphocytic leukemia, iNHL) may cause an increase of IFI for which antifungal strategies (prophylaxis and treatments) are not well defined.
These issues have led to a change in the antifungal approach in clinical practice, where often the empirical or pre-emptive approaches use criteria other than those of the EORTC/MSG definitions.
“Real-life” studies have become increasingly popular recently. However, these require more appropriate definitions that recognize IFIs (e.g. the detection of biomarkers) as well as clinical signs that suggest invasive fungal disease although not meeting the EORTC/MSG criteria of possible or probable invasive fungal disease, not least because a substantial number of patients present with non-specific radiological findings.
The primary objective of the present study is to update the existing EORTC/MSG criteria based on observation and analysis of their application in the contemporary clinical practice. In this way the project aims at developing clinically relevant criteria for both IFI and potential IFI and their treatments (particularly empirical and pre-emptive) updated the basis of the changing needs of the clinicians and according to the most recent knowledge.