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Defining Opportunistic Invasive Fungal Infections in Immunocompromised Patients with Cancer and Hematopoietic Stem Cell Transplants: An International Consensus

  1. Invasive Fungal Infections Cooperative Group of the European Organization for Research and Treatment of Cancer and Mycoses Study Group of the National Institute of Allergy and Infectious Diseases
  1. 1European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group, Brussels
  2. 2National Institute of Allergy and Infectious Diseases Mycoses Study Group, National Institutes of Health, Bethesda, Maryland
  1. Reprints or correspondence: Dr. Thomas J. Walsh, National Cancer Institute, 9000 Rockville Pike, Bldg. 10, Rm. 13N240, Bethesda, MD 20892 (walsht{at}mail.nih.gov).

Abstract

During the past several decades, there has been a steady increase in the frequency of opportunistic invasive fungal infections (IFIs) in immunocompromised patients. However, there is substantial controversy concerning optimal diagnostic criteria for these IFIs. Therefore, members of the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group formed a consensus committee to develop standard definitions for IFIs for clinical research. On the basis of a review of literature and an international consensus, a set of research-oriented definitions for the IFIs most often seen and studied in immunocompromised patients with cancer is proposed. Three levels of probability are proposed: “proven,” “probable,” and “possible.” The definitions are intended for use in the context of clinical and/or epidemiological research, not for clinical decision making.

Footnotes

  • Financial support: Unrestricted educational grant from Pfizer (to S.A.); European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group (to S.A.); Aronex, Janssen Research Foundation, Liposome Company, NeXstar-Gilead, and Pfizer.

  • Received November 3, 2000.
  • Revision received May 14, 2001.
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