2017/06/30 by Simone Cesaro, Gloria Tridello, Elio Castagnola +10
paper · doi:10.1111/ejh.12910
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.