The diagnosis and treatment of invasive aspergillosis in Dutch haematology units facing a rapidly increasing prevalence of azole-resistance. A nationwide survey and rationale for the DB-MSG 002 study protocol

Alexander F. A. D. Schauwvlieghe, Nick de Jonge, Karin van Dijk, Paul E. Verweij, Roger J. Brüggemann, Bart J. Biemond, Aldert Bart, Peter A. von dem Borne, Annelies Verbon, Martha T. van der Beek, Astrid M. P. Demandt, Guy J. Oudhuis, Jan J. Cornelissen, Walter J. F. M. van der Velden, Lambert F. R. Span, Greetje A. Kampinga, Anke H. Bruns, Alieke G. Vonk, Pieter–Jan A. Haas, Jeanette K. Doorduijn & 1 others Bart J. A. Rijnders

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Patients with haematological malignancies are at risk for invasive fungal diseases (IFD). A survey was conducted in all Dutch academic haematology centres on their current diagnostic, prophylactic and therapeutic approach towards IFD in the context of azole-resistance. In all 8 centres, a haematologist and microbiologist filled in the questionnaire that focused on different subgroups of haematology patients. Fungal prophylaxis during neutropaenia was directed against Candida and consisted of fluconazole and/or amphotericin B suspension. Mould-active prophylaxis was given to acute myeloid leukaemia patients during chemotherapy in 2 of 8 centres. All centres used azole prophylaxis in a subset of patients with graft-versus-host disease. A uniform approach towards the diagnosis and treatment of IFD and in particular azole-resistant Aspergillus fumigatus was lacking. In 2017, all centres agreed to implement a uniform diagnostic and treatment algorithm regarding invasive aspergillosis with a central role for comprehensive diagnostics and PCR-based detection of azole-resistance. This study (DB-MSG 002) will re-evaluate this algorithm when 280 patients have been treated. A heterogeneous approach towards antifungal prophylaxis, diagnosis and treatment was apparent in the Netherlands. Facing triazole-resistance, consensus was reached on the implementation of a uniform diagnostic approach in all 8 centres.
Original languageEnglish
Pages (from-to)656-664
JournalMycoses
Volume61
Issue number9
DOIs
Publication statusPublished - 2018

Cite this

Schauwvlieghe, Alexander F. A. D. ; de Jonge, Nick ; van Dijk, Karin ; Verweij, Paul E. ; Brüggemann, Roger J. ; Biemond, Bart J. ; Bart, Aldert ; von dem Borne, Peter A. ; Verbon, Annelies ; van der Beek, Martha T. ; Demandt, Astrid M. P. ; Oudhuis, Guy J. ; Cornelissen, Jan J. ; van der Velden, Walter J. F. M. ; Span, Lambert F. R. ; Kampinga, Greetje A. ; Bruns, Anke H. ; Vonk, Alieke G. ; Haas, Pieter–Jan A. ; Doorduijn, Jeanette K. ; Rijnders, Bart J. A. / The diagnosis and treatment of invasive aspergillosis in Dutch haematology units facing a rapidly increasing prevalence of azole-resistance. A nationwide survey and rationale for the DB-MSG 002 study protocol. In: Mycoses. 2018 ; Vol. 61, No. 9. pp. 656-664.
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title = "The diagnosis and treatment of invasive aspergillosis in Dutch haematology units facing a rapidly increasing prevalence of azole-resistance. A nationwide survey and rationale for the DB-MSG 002 study protocol",
abstract = "Patients with haematological malignancies are at risk for invasive fungal diseases (IFD). A survey was conducted in all Dutch academic haematology centres on their current diagnostic, prophylactic and therapeutic approach towards IFD in the context of azole-resistance. In all 8 centres, a haematologist and microbiologist filled in the questionnaire that focused on different subgroups of haematology patients. Fungal prophylaxis during neutropaenia was directed against Candida and consisted of fluconazole and/or amphotericin B suspension. Mould-active prophylaxis was given to acute myeloid leukaemia patients during chemotherapy in 2 of 8 centres. All centres used azole prophylaxis in a subset of patients with graft-versus-host disease. A uniform approach towards the diagnosis and treatment of IFD and in particular azole-resistant Aspergillus fumigatus was lacking. In 2017, all centres agreed to implement a uniform diagnostic and treatment algorithm regarding invasive aspergillosis with a central role for comprehensive diagnostics and PCR-based detection of azole-resistance. This study (DB-MSG 002) will re-evaluate this algorithm when 280 patients have been treated. A heterogeneous approach towards antifungal prophylaxis, diagnosis and treatment was apparent in the Netherlands. Facing triazole-resistance, consensus was reached on the implementation of a uniform diagnostic approach in all 8 centres.",
author = "Schauwvlieghe, {Alexander F. A. D.} and {de Jonge}, Nick and {van Dijk}, Karin and Verweij, {Paul E.} and Br{\"u}ggemann, {Roger J.} and Biemond, {Bart J.} and Aldert Bart and {von dem Borne}, {Peter A.} and Annelies Verbon and {van der Beek}, {Martha T.} and Demandt, {Astrid M. P.} and Oudhuis, {Guy J.} and Cornelissen, {Jan J.} and {van der Velden}, {Walter J. F. M.} and Span, {Lambert F. R.} and Kampinga, {Greetje A.} and Bruns, {Anke H.} and Vonk, {Alieke G.} and Haas, {Pieter–Jan A.} and Doorduijn, {Jeanette K.} and Rijnders, {Bart J. A.}",
year = "2018",
doi = "10.1111/myc.12788",
language = "English",
volume = "61",
pages = "656--664",
journal = "Mycoses",
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Schauwvlieghe, AFAD, de Jonge, N, van Dijk, K, Verweij, PE, Brüggemann, RJ, Biemond, BJ, Bart, A, von dem Borne, PA, Verbon, A, van der Beek, MT, Demandt, AMP, Oudhuis, GJ, Cornelissen, JJ, van der Velden, WJFM, Span, LFR, Kampinga, GA, Bruns, AH, Vonk, AG, Haas, PJA, Doorduijn, JK & Rijnders, BJA 2018, 'The diagnosis and treatment of invasive aspergillosis in Dutch haematology units facing a rapidly increasing prevalence of azole-resistance. A nationwide survey and rationale for the DB-MSG 002 study protocol' Mycoses, vol. 61, no. 9, pp. 656-664. https://doi.org/10.1111/myc.12788

The diagnosis and treatment of invasive aspergillosis in Dutch haematology units facing a rapidly increasing prevalence of azole-resistance. A nationwide survey and rationale for the DB-MSG 002 study protocol. / Schauwvlieghe, Alexander F. A. D.; de Jonge, Nick; van Dijk, Karin; Verweij, Paul E.; Brüggemann, Roger J.; Biemond, Bart J.; Bart, Aldert; von dem Borne, Peter A.; Verbon, Annelies; van der Beek, Martha T.; Demandt, Astrid M. P.; Oudhuis, Guy J.; Cornelissen, Jan J.; van der Velden, Walter J. F. M.; Span, Lambert F. R.; Kampinga, Greetje A.; Bruns, Anke H.; Vonk, Alieke G.; Haas, Pieter–Jan A.; Doorduijn, Jeanette K.; Rijnders, Bart J. A.

In: Mycoses, Vol. 61, No. 9, 2018, p. 656-664.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - The diagnosis and treatment of invasive aspergillosis in Dutch haematology units facing a rapidly increasing prevalence of azole-resistance. A nationwide survey and rationale for the DB-MSG 002 study protocol

AU - Schauwvlieghe, Alexander F. A. D.

AU - de Jonge, Nick

AU - van Dijk, Karin

AU - Verweij, Paul E.

AU - Brüggemann, Roger J.

AU - Biemond, Bart J.

AU - Bart, Aldert

AU - von dem Borne, Peter A.

AU - Verbon, Annelies

AU - van der Beek, Martha T.

AU - Demandt, Astrid M. P.

AU - Oudhuis, Guy J.

AU - Cornelissen, Jan J.

AU - van der Velden, Walter J. F. M.

AU - Span, Lambert F. R.

AU - Kampinga, Greetje A.

AU - Bruns, Anke H.

AU - Vonk, Alieke G.

AU - Haas, Pieter–Jan A.

AU - Doorduijn, Jeanette K.

AU - Rijnders, Bart J. A.

PY - 2018

Y1 - 2018

N2 - Patients with haematological malignancies are at risk for invasive fungal diseases (IFD). A survey was conducted in all Dutch academic haematology centres on their current diagnostic, prophylactic and therapeutic approach towards IFD in the context of azole-resistance. In all 8 centres, a haematologist and microbiologist filled in the questionnaire that focused on different subgroups of haematology patients. Fungal prophylaxis during neutropaenia was directed against Candida and consisted of fluconazole and/or amphotericin B suspension. Mould-active prophylaxis was given to acute myeloid leukaemia patients during chemotherapy in 2 of 8 centres. All centres used azole prophylaxis in a subset of patients with graft-versus-host disease. A uniform approach towards the diagnosis and treatment of IFD and in particular azole-resistant Aspergillus fumigatus was lacking. In 2017, all centres agreed to implement a uniform diagnostic and treatment algorithm regarding invasive aspergillosis with a central role for comprehensive diagnostics and PCR-based detection of azole-resistance. This study (DB-MSG 002) will re-evaluate this algorithm when 280 patients have been treated. A heterogeneous approach towards antifungal prophylaxis, diagnosis and treatment was apparent in the Netherlands. Facing triazole-resistance, consensus was reached on the implementation of a uniform diagnostic approach in all 8 centres.

AB - Patients with haematological malignancies are at risk for invasive fungal diseases (IFD). A survey was conducted in all Dutch academic haematology centres on their current diagnostic, prophylactic and therapeutic approach towards IFD in the context of azole-resistance. In all 8 centres, a haematologist and microbiologist filled in the questionnaire that focused on different subgroups of haematology patients. Fungal prophylaxis during neutropaenia was directed against Candida and consisted of fluconazole and/or amphotericin B suspension. Mould-active prophylaxis was given to acute myeloid leukaemia patients during chemotherapy in 2 of 8 centres. All centres used azole prophylaxis in a subset of patients with graft-versus-host disease. A uniform approach towards the diagnosis and treatment of IFD and in particular azole-resistant Aspergillus fumigatus was lacking. In 2017, all centres agreed to implement a uniform diagnostic and treatment algorithm regarding invasive aspergillosis with a central role for comprehensive diagnostics and PCR-based detection of azole-resistance. This study (DB-MSG 002) will re-evaluate this algorithm when 280 patients have been treated. A heterogeneous approach towards antifungal prophylaxis, diagnosis and treatment was apparent in the Netherlands. Facing triazole-resistance, consensus was reached on the implementation of a uniform diagnostic approach in all 8 centres.

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UR - https://www.ncbi.nlm.nih.gov/pubmed/29687483

U2 - 10.1111/myc.12788

DO - 10.1111/myc.12788

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JO - Mycoses

JF - Mycoses

SN - 0933-7407

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