Invasive aspergillosis in acute leukemias: old and new risk factors and epidemiological trends

In recent years, there has been increased interest in the development of prophylactic\r\nand diagnostic tools for patients at high risk for invasive aspergillosis (IA), resulting in\r\na signifi cant investment of human, technical, and economic resources. There are several\r\nclassic risk factors for the development of IA, including neutropenia, graft-versus-host\r\ndisease, and corticosteroid use. However, despite having similar risk profi les, only a\r\nsubset of at-risk individuals will develop this fungal complication. At present, there is\r\na signifi cant expansion of the classically defi ned ‘ high-risk ’ group due to the ageing of\r\nthe general population, the intensifi cation of treatment strategies, and the introduction\r\nof new drugs into clinical practice (e.g., monoclonal antibodies, TNF inhibitors). Therefore,\r\nan improved categorization of patients would be useful in order to better target\r\navailable resources and avoid the risk of potential overtreatment and toxicities.