{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T16:22:08Z","timestamp":1775060528730,"version":"3.50.1"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"S2","license":[{"start":{"date-parts":[[2007,10,1]],"date-time":"2007-10-01T00:00:00Z","timestamp":1191196800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2007,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Invasive fungal infection in severely immunosuppressed patients with acute myelogenous leukemia (AML) remains a serious challenge because (a) of the higher rates of non\u2013drug susceptible fungal sinopulmonary disease; (b) despite advances in diagnostic fungal assays, the correct identification of causative organism(s) is difficult, and antifungal drug susceptibility data are seldom available during clinical decision making; and (c) the increasing frequencies of zygomycosis, scedosporiosis, and highly virulent Candida tropicalis infection have undermined the gains attributed to effective anti-Aspergillus drug therapy. Recombinant cytokines, such as recombinant human (rh)GM-CSF and interferon (IFN)-\u03b3, have been explored to augment host antifungal immune responses. These cytokines promote activation and recruitment of granulocyte and mononuclear phagocytic effector cells. Prophylaxis with rhGM-CSF was associated with significantly fewer life-threatening and serious (grade \u22653) infections, especially in older patients undergoing treatment for AML. The limited experience with rhGM-CSF for the treatment of invasive fungal infections in combination with antifungal drug(s) was associated with a favorable outcome, and in contrast to Escherichia coli\u2013derived rhGM-CSF, the new preparation (sargramostim) was well tolerated and rarely associated with serious systemic toxicities. Similarly, IFN-\u03b3 has been successfully used in patients with antimicrobial drug\u2013refractory and\/or disseminated fungal infection. Most patients tolerate the T-helper type 1 protagonist cytokine without serious adverse events. In difficult-to-treat fungal infections, the addition of cytokines appears to improve outcome and may be considered early in severely immunosuppressed patients with AML.<\/jats:p>","DOI":"10.1634\/theoncologist.12-s2-2","type":"journal-article","created":{"date-parts":[[2020,2,10]],"date-time":"2020-02-10T11:25:42Z","timestamp":1581333942000},"page":"2-6","source":"Crossref","is-referenced-by-count":21,"title":["Difficulties with Fungal Infections in Acute Myelogenous Leukemia Patients: Immune Enhancement Strategies"],"prefix":"10.1093","volume":"12","author":[{"given":"Amar","family":"Safdar","sequence":"first","affiliation":[{"name":"The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2007,10,1]]},"reference":[{"key":"2021122208422100200_R1","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1086\/322606","article-title":"Trends in mortality due to invasive mycotic diseases in the United States, 1980\u20131997","volume":"33","author":"McNeil","year":"2001","journal-title":"Clin Infect Dis"},{"key":"2021122208422100200_R2","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1086\/502581","article-title":"Excess mortality, hospital stay, and cost due to candidemia: A case-control study using data from population-based candidemia surveillance","volume":"26","author":"Morgan","year":"2005","journal-title":"Infect Control Hosp Epidemiol"},{"key":"2021122208422100200_R3","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1086\/318483","article-title":"Aspergillosis case-fatality rate: Systematic review of the literature","volume":"32","author":"Lin","year":"2001","journal-title":"Clin Infect Dis"},{"key":"2021122208422100200_R4","doi-asserted-by":"crossref","first-page":"1546","DOI":"10.1056\/NEJMoa022139","article-title":"The epidemiology of sepsis in the United States from 1979 through 2000","volume":"348","author":"Martin","year":"2003","journal-title":"N Engl J Med"},{"key":"2021122208422100200_R5","doi-asserted-by":"crossref","first-page":"1580","DOI":"10.1086\/509579","article-title":"Scedosporium infection in a tertiary care cancer center: A review of 25 cases from 1989\u20132006","volume":"43","author":"Lamaris","year":"2006","journal-title":"Clin Infect Dis"},{"key":"2021122208422100200_R6","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1086\/323335","article-title":"Defining opportunistic invasive fungal infections in immunocompromised patients with cancer and hematopoietic stem cell transplants: An international consensus","volume":"34","author":"Ascioglu","year":"2002","journal-title":"Clin Infect Dis"},{"key":"2021122208422100200_R7","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1086\/509917","article-title":"Imaging findings in acute invasive pulmonary aspergillosis: Clinical significance of the halo sign","volume":"44","author":"Greene","year":"2007","journal-title":"Clin Infect Dis"},{"key":"2021122208422100200_R8","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1038\/sj.bmt.1705439","article-title":"Strategies to enhance immune function in hematopoietic transplantation recipients who have fungal infections","volume":"38","author":"Safdar","year":"2006","journal-title":"Bone Marrow Transplant"},{"key":"2021122208422100200_R9","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1093\/clinids\/23.3.608","article-title":"Therapeutic outcome in invasive aspergillosis","volume":"23","author":"Denning","year":"1996","journal-title":"Clin Infect Dis"},{"key":"2021122208422100200_R10","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1056\/NEJMoa020191","article-title":"Invasive Fungal Infections Group of the European Organisation for Research and Treatment of Cancer and the Global Aspergillus Study Group. 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