Immunotherapy for Invasive Mold Disease in Transplant Patients: Dendritic Cell Immunotherapy, Interferon Gamma, Recombinant Myeloid Growth Factors, and Healthy Donor Granulocyte Transfusions

Over the last half-century, there has been a steady increase in opportunistic fungal infections due to the growth in population of patients with severe and mostly iatrogenically induced immune suppression. The explosive growth of this challenge in opportunistic fungal disease has been fueled in recent decades by advances in solid organ and hematopoietic stem cell transplantation. Furthermore, use of high-dose antineoplastic chemotherapy and biologic immunosuppressive regimens in oncology and clinical practice has further escalated the risk for opportunistic infections. Systemic antifungal therapies that work relatively well within the general population are far less efficacious in patients with severe immune dysregulation. This provides an important thrust and impetus for exploring novel antifungal immune modulation strategies. Here we outline a variety of potential novel adjunct treatment paradigms in the areas of whole cell, cytokine, and small-molecule therapies that may assist in amelioration of invasive fungal disease among patients in the setting of transplantation.