Antibacterial, antifungal and antiviral prophylaxis and vaccination strategies in adult patients with acute myeloid and promyelocytic leukemia: An expert panel consensus from the GIMEMA group - PubMed
3 hours ago
- #Infection Prevention
- #Antimicrobial Prophylaxis
- #Leukemia Management
- Infections are a leading cause of morbidity, mortality, and treatment delays in acute myeloid leukemia (AML) and acute promyelocytic leukemia (APL).
- A GIMEMA expert panel consensus was developed via Delphi/nominal group methods, reviewing literature from 2012-2025 and achieving ≥70% consensus.
- Fluoroquinolone prophylaxis is not recommended for intensive chemotherapy, venetoclax-based regimens, or low-intensity/palliative care due to lack of survival benefit, MDR pressure, and microbiota disruption.
- Posaconazole prophylaxis is advised for intensive chemotherapy (with or without FLT3 inhibitors), venetoclax-based regimens, and HMA with or without ivosidenib (first 4 cycles), but not for APL or palliative care.
- Antiviral prophylaxis is recommended for APL patients receiving arsenic trioxide, with limited evidence for other scenarios.
- Universal vaccination against pneumococcal disease, influenza, SARS-CoV-2, and herpes zoster is supported for these patients.