Risks and outcome of fungal infection in neutropenic children with hematologic diseases.

In this retrospective study, we report the results of antifungal treatments (AFTs) in febrile neutropenic episodes in patients with acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML) and aplastic anemia (AA) in our center. From January 2004 to December 2005, a total of 52 patients and 221 febrile neutropenic episodes were evaluated. AFT was started in 96 (43%) of the 221 episodes. Amphotericin B and fluconazole were used in 44 (46%) and 52 (54%) febrile neutropenic episodes, respectively. Microbiologically or histopathologically evident fungal infections were detected in 35 of 96 febrile neutropenic episodes. The mortality rate due to fungal infection was higher in patients with AA (7/8 patients) and AML (7/12 patients) than in ALL patients (1/32). Mortality for the whole group was 28%. When the mortality rate was compared between the two treatment groups (amphotericin B vs fluconazole), mortality was significantly higher in patients receiving amphotericin B [n = 14 (93%) and n = 1 (7%), respectively].

[1]  M. Cuenca‐Estrella,et al.  Increasing Incidence of Invasive Aspergillosis in Pediatric Hematology Oncology Patients Over the Last Decade: A Retrospective Single Centre Study , 2009, Journal of pediatric hematology/oncology.

[2]  B. Segal,et al.  Prevention and treatment of invasive fungal diseases in neutropenic patients , 2009, Current opinion in infectious diseases.

[3]  A. Vekhoff,et al.  Empirical versus preemptive antifungal therapy for high-risk, febrile, neutropenic patients: a randomized, controlled trial. , 2009, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[4]  A. Kalkancı,et al.  Invasive fungal infections in pediatric leukemia patients receiving fluconazole prophylaxis , 2009, Pediatric blood & cancer.

[5]  T. Lehrnbecher,et al.  Current practice of antifungal prophylaxis and treatment in immunocompromised children and adults with malignancies: a single centre approach , 2009, Mycoses.

[6]  L. Leibovici,et al.  Empirical antifungal therapy for patients with neutropenia and persistent fever: Systematic review and meta-analysis. , 2008, European journal of cancer.

[7]  Y. Bertrand,et al.  Invasive aspergillosis in a paediatric haematology department: a 15‐year review , 2008, Mycoses.

[8]  B. Otlu,et al.  Epidemiological Characteristics of Fatal Candida krusei Fungemia in Immunocompromised Febrile Neutropenic Children , 2008, Infection.

[9]  C. Mussini,et al.  Epidemiology of candidaemia and antifungal susceptibility patterns in an Italian tertiary-care hospital. , 2006, Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases.

[10]  R. Hasan,et al.  Invasive Aspergillosis in Children with Hematologic Malignancies , 2006, Paediatric drugs.

[11]  U. Nawrot,et al.  Susceptibility to antifungal agents of Candida species isolated from paediatric and adult patients with haematological diseases , 2005, Mycoses.

[12]  W. Steinbach.  Pediatric Aspergillosis: Disease and Treatment Differences in Children , 2005, The Pediatric infectious disease journal.

[13]  P. Nathan,et al.  Prophylactic granulocyte colony-stimulating factor and granulocyte-macrophage colony-stimulating factor decrease febrile neutropenia after chemotherapy in children with cancer: a meta-analysis of randomized controlled trials. , 2004, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[14]  J. Wingard.  Empirical antifungal therapy in treating febrile neutropenic patients. , 2004, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[15]  W. Powderly,et al.  A prospective observational study of candidemia: epidemiology, therapy, and influences on mortality in hospitalized adult and pediatric patients. , 2003, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[16]  M. Maris,et al.  Risks and outcomes of invasive fungal infections in recipients of allogeneic hematopoietic stem cell transplants after nonmyeloablative conditioning. , 2003, Blood.

[17]  M. Boogaerts,et al.  Assessing risk factors for systemic fungal infections. , 2001, European journal of cancer care.

[18]  K. Vettenranta,et al.  Invasive fungal infections in pediatric bone marrow transplant recipients: single center experience of 10 years , 2000, Bone Marrow Transplantation.

[19]  J. Shenep,et al.  Aspergillosis in children with cancer: A 34-year experience. , 1999, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[20]  D. Weisdorf,et al.  Infections in recipients of blood and marrow transplantation. , 1999, Hematology/oncology clinics of North America.

[21]  B. Lebeau,et al.  Candidemia in cancer patients: a prospective, multicenter surveillance study by the Invasive Fungal Infection Group (IFIG) of the European Organization for Research and Treatment of Cancer (EORTC). , 1999, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[22]  D. Snydman,et al.  The changing face of candidemia: emergence of non-Candida albicans species and antifungal resistance. , 1996, The American journal of medicine.