Invasive Fungal Infections in Hematological Malignancies

Invasive fungal infections represent a major complication in patients with haematological malignancies, particularly those undergoing intensive chemotherapy or hematopoietic stem cell transplantation. Profound neutropenia, mucosal barrier injury and central venous catheters facilitate translocation or inhalation of fungal pathogens. While Candida and Aspergillus species remain predominant, emerging yeasts and moulds such as Saprochaete clavata, Magnusiomyces spp. and Mucorales are increasingly implicated. Clinical manifestations range from febrile neutropenia and candidaemia to hepatosplenic abscesses and pulmonary nodules. Diagnosis relies on a combination of culture, imaging and non-culture biomarkers—including galactomannan and β-D-glucan—augmented by molecular and proteomic techniques. Antifungal prophylaxis and pre-emptive strategies have reduced empirical treatment but have also driven antifungal resistance. A nuanced risk stratification that integrates host factors, pathogen susceptibility and local epidemiology is essential for early targeted therapy. Global surveillance underscores the importance of novel diagnostics and expanded antifungal agents to counteract evolving resistance patterns and emerging species.

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Invasive Fungal Infections in Hematological Malignancies publication trend

The graph below shows the total number of articles in invasive fungal infections in hematological malignancies across all publications each year (not limited to Nature Index journals).

Technical terms

Neutropenia: A marked reduction in circulating neutrophils, increasing vulnerability to invasive infections.

Antifungal prophylaxis: Administration of antifungal agents to prevent infection in high-risk patients.

Fungemia: Presence of viable fungal organisms in the bloodstream, often leading to systemic dissemination.

Galactomannan: A polysaccharide antigen released by Aspergillus species, used as a serum biomarker.

Chronic disseminated candidiasis: Deep-seated candidal infection characterised by hepatic and splenic microabscesses in immunocompromised hosts.

References

1. Treatment of invasive fungal diseases in cancer patients—Revised 2019 Recommendations of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Oncology (DGHO). Mycoses (2020).
2. Outbreak of Saprochaete clavata Sepsis in Hematology Patients: Combined Use of MALDI-TOF and Sequencing Strategy to Identify and Correlate the Episodes. Frontiers in Microbiology (2020).
3. Chronic disseminated candidiasis manifesting as hepatosplenic abscesses among patients with hematological malignancies. BMC Infectious Diseases (2019).
4. Bloodstream Infections Caused by Magnusiomyces capitatus and Magnusiomyces clavatus: Epidemiological, Clinical, and Microbiological Features of Two Emerging Yeast Species. Antimicrobial Agents and Chemotherapy (2021).