Report on a European Science Foundation workshop on invasive aspergillosis
Author:
Dr David W Denning, Dr Jean-Paul Latge, Professor Pietro Martino, Dennis Dixon, Dr Albert Pahissa, Dr Chris Poynton, Professor Paulo Grossi, Dr Emmanuel Roilides, Dr Stephan Bretagne, Dr Reinhard Ruchel, Dr Juan-Luis Rodriguez-Tudela, Dr J Brown
Date: 1 June 1999
Abstract:
Dr Denning welcomed the participants. He described the size of the problem of invasive aspergillosis (IA) in terms of its incidence in different patient populations:Lung transplantation 17-26 %Allogeneic bone marrow transplantation 5-15 %Acute leukaemia 5-24 %Heart transplantation 2-13 %Pancreas transplantation 1-4 %Renal transplantation 0.5-10 %AIDS 0-12 %Multiple myeloma (stage III) ~4 %Severe combined immunodeficiency ~4 %Solid tumour and lymphoma ~1-3 %Autologous BMT (with growth factors) ~1 %Connective tissue diseases (e.g. SLE) ~1 %Non-immunocompromised patients <1 %He noted the high mortality of invasive aspergillosis (50 to100 %) even with therapy and discussed the report from Frankfurt (Groll et al., J Infection 1996; 33: 23-32) which showed a 14-fold rise (over 12 years) in the incidence of invasive aspergillosis at autopsy. He presented antifungal sales figures from 1997 from Europe, USA and Japan of which $370 M from a total of $1230 M was spent on the only two licensed drugs with activity against Aspergillus - amphotericin B and itraconazole. He emphasised that invasive aspergillosis is now the leading cause of early death in many transplant centres and has a major impact on the management of leukaemia.Dr Denning then presented an overview of strategies to address this problem (Figure I.). Subsequent contributions to the workshop were specifically targeted to one or more of these issues.
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