Prospettive future

La rilevanza della Malattia Fungina Invasiva nei pazienti oncoematologici ha determinato notevoli progressi nello studio di questa temibile complicanza. Negli ultimi anni sono stati studiati diversi nuovi aspetti della malattia, che potranno in futuro essere presi in considerazione nella gestione routinaria della MFI in questi pazienti. Per quanto riguarda la stratificazione del rischio nei pazienti oncoematologici, il sovraccarico di ferro, valutato attraverso il dosaggio della ferritina sierica, viene da anni preso in considerazione e studiato come possibile fattore di rischio per lo sviluppo di MFI235,236_. Studi recenti hanno messo in evidenza la presenza di una suscettibilità all’infezione invasiva fungina in pazienti con particolari polimorfismi genetici (in particolare di TLR – Toll-like Receptor)237-239_{. Dal punto di} vista diagnostico, sempre maggior interesse è rivolto alle tecniche di biologia molecolare, che sono ormai studiate da molti anni in questo tipo di infezioni, e che consentiranno, una volta messi a punto metodi standardizzati, di aumentare le capacità diagnostiche nei pazienti a rischio con l’obiettivo di giungere a una diagnosi sempre più precoce166,240-242_{. Anche dal punto di vista terapeutico si stanno} compiendo progressi nel campo della ricerca di nuovi agenti farmacologici e di nuove strategie innovative che consentano di migliorare la prognosi di questi pazienti243_.

Capitolo 8. Conclusioni

Numerosi progressi sono stati compiuti nello studio e nella gestione della Malattia Fungina Invasiva nei pazienti sottoposti a Trapianto di Cellule Staminali Emopoietiche.

Nonostante questo, essa rappresenta ancora una complicanza temibile e gravata da un’elevata mortalità.

La stratificazione del rischio attraverso l’identificazione di fattori predisponenti e di fattori prognostici, l’adozione di tecniche diagnostiche valide e la messa a punto di strategie profilattiche e terapeutiche efficaci può contribuire alla riduzione del rischio di infezione e al miglioramento della prognosi di questi pazienti.

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