Simone Cesaro1, Gloria Tridello1, Elio Castagnola2, Elisabetta Calore3, Francesca Carraro4, Ilaria Mariotti5, Antonella Colombini6, Katia Perruccio7, Nunzia Decembrino8, Giovanna Russo9, Natalia Maximova10, Valentina Baretta1, Désirée Caselli11. 1. Pediatric Hematology Oncology, Azienda Ospedaliera Universitaria Integrata, Verona, Italy. 2. Pediatric Infectious Disease, Istituto Giannina Gaslini, Genoa, Italy. 3. Department of Women's and Children's Health, Clinic of Pediatric Hemato-Oncology, University Hospital of Padova, Padova, Italy. 4. Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, AOU Città della Salute e della Scienza, Regina Margherita Childrens Hospital, Turin, Italy. 5. Pediatric Hematology Oncology, Azienda Ospedaliera Universitaria, Modena, Italy. 6. Clinic of Pediatrics, San Gerardo Hospital, Monza, Italy. 7. Pediatric Hematology Oncology, Azienda Ospedaliera Universitaria, Perugia, Italy. 8. Pediatric Hematology Oncology, IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy. 9. Pediatric Hematology Oncology, A.O.U. Policlinico-Vittorio Emanuele Catania, Catania, Italy. 10. Bone Marrow Transplant Unit, Institute for Maternal and Child Health - IRCCS Burlo Garofolo, Trieste, Italy. 11. Pediatric Hematology Oncology, Meyer Hospital, University of Florence, Firenze, Italy.
Abstract
BACKGROUND: Invasive fungal infection (IFI) is a cause of morbidity, mortality and increased health costs in children undergoing chemotherapy or hematopoietic stem cell transplant (HSCT). METHODS: Multicenter, retrospective study to assess the incidence, outcome of proven and probable IFI (PP-IFI) in children treated for acute leukemia, non-Hodgkin lymphoma or who underwent HSCT from 2006 to 2012. RESULTS: Over the 7-year period, 127 PP-IFI were diagnosed in 123 patients, median age of 9.7 years. The 1-year cumulative incidence was 2.5% (CI 1.8-3.7) after frontline chemotherapy, 9.4% (CI 5.8-15.0) after relapse, and 5.3% (CI 3.9-7.1) after HSCT. Severe neutropenia was present in 98 (77%) patients. Culture-proven agents were Candida spp., mostly non-albicans, 28, mold 23, whereas three proven IFI were identified by histopathology. Favorable response to treatment within 3 months from diagnosis was observed in 77 (89%). The overall ninety-day probability of survival was 68% (CI 59-76). CONCLUSIONS: About two-thirds of pediatric patients with PP-IFI survived, regardless of whether the infection occurred after frontline chemotherapy, reinduction chemotherapy for disease relapse, or after HSCT. Further prospective studies are needed to define the impact of antifungal prophylaxis and early combination therapy on short-term overall survival.
BACKGROUND: Invasive fungal infection (IFI) is a cause of morbidity, mortality and increased health costs in children undergoing chemotherapy or hematopoietic stem cell transplant (HSCT). METHODS: Multicenter, retrospective study to assess the incidence, outcome of proven and probable IFI (PP-IFI) in children treated for acute leukemia, non-Hodgkin lymphoma or who underwent HSCT from 2006 to 2012. RESULTS: Over the 7-year period, 127 PP-IFI were diagnosed in 123 patients, median age of 9.7 years. The 1-year cumulative incidence was 2.5% (CI 1.8-3.7) after frontline chemotherapy, 9.4% (CI 5.8-15.0) after relapse, and 5.3% (CI 3.9-7.1) after HSCT. Severe neutropenia was present in 98 (77%) patients. Culture-proven agents were Candida spp., mostly non-albicans, 28, mold 23, whereas three proven IFI were identified by histopathology. Favorable response to treatment within 3 months from diagnosis was observed in 77 (89%). The overall ninety-day probability of survival was 68% (CI 59-76). CONCLUSIONS: About two-thirds of pediatric patients with PP-IFI survived, regardless of whether the infection occurred after frontline chemotherapy, reinduction chemotherapy for disease relapse, or after HSCT. Further prospective studies are needed to define the impact of antifungal prophylaxis and early combination therapy on short-term overall survival.
Authors: N Decembrino; K Perruccio; M Zecca; A Colombini; E Calore; P Muggeo; E Soncini; A Comelli; M Molinaro; B M Goffredo; S De Gregori; I Giardini; L Scudeller; S Cesaro Journal: Antimicrob Agents Chemother Date: 2020-02-21 Impact factor: 5.191
Authors: Thomas Lehrnbecher; Stefan Schöning; Fiona Poyer; Jamina Georg; Andreas Becker; Kathrin Gordon; Andishe Attarbaschi; Andreas H Groll Journal: Front Microbiol Date: 2019-04-16 Impact factor: 5.640