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Review
. 2023 May 19;9(5):592.
doi: 10.3390/jof9050592.

Clinical Features and Treatment Progress of Invasive Mucormycosis in Patients with Hematological Malignancies

Nuobing Yang  1   2 , Lining Zhang  1   2 , Sizhou Feng  1   2
Affiliations
Review

Clinical Features and Treatment Progress of Invasive Mucormycosis in Patients with Hematological Malignancies

Nuobing Yang et al. J Fungi (Basel). .

Abstract

The incidence rate of invasive mucormycosis (IM) in patients with hematological malignancies (HMs) is increasing year by year, ranging from 0.07% to 4.29%, and the mortality rate is mostly higher than 50%. With the ongoing pandemic of COVID-19, COVID-19-associated mucormycosis (CAM) also became a global health threat. Patients with high risk factors such as active HMs, relapsed/refractory leukemia, prolonged neutropenia may still develop breakthrough mucormycosis (BT-MCR) even under the prophylaxis of Mucorales-active antifungals, and such patients often have higher mortality. Rhizopus spp. is the most common genus associated with IM, followed by Mucor spp. and Lichtheimia spp. Pulmonary mucormycosis (PM) is the most common form of IM in patients with HMs, followed by rhino-orbital-cerebral mucormycosis (ROCM) and disseminated mucormycosis. The prognosis of IM patients with neutrophil recovery, localized IM and receiving early combined medical-surgical therapy is usually better. As for management of the disease, risk factors should be eliminated firstly. Liposome amphotericin B (L-AmB) combined with surgery is the initial treatment scheme of IM. Those who are intolerant to L-AmB can choose intravenous formulations or tablets of isavuconazole or posaconazole. Patients who are refractory to monotherapy can turn to combined antifungals therapy.

Keywords: clinical manifestations; hematological malignancies; high risk factors; invasive mucormycosis; treatment.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Distribution of Mucorales organisms causing infection.
Figure 2
Figure 2
Sites of IM in patients with HMs [2,3,7,9,10,11,13,17,19,33,36].
Figure 3
Figure 3
Proportion of various types of IM differentiated by sites in patients with HMs.
See this image and copyright information in PMC

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