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Incidence and outcome of invasive fungal diseases in children with hematological malignancies and/or allogeneic hematopoietic stem cell transplantation : results of a prospective multicenter study

  • Background: Available data on the incidence and outcome of invasive fungal diseases (IFD) in children with hematological malignancies or after allogeneic hematopoietic stem cell transplantation (HSCT) are mostly based on monocenter, retrospective studies or on studies performed prior to the availability of newer triazoles or echinocandins. Procedure: We prospectively collected clinical data on incidence, diagnostic procedures, management and outcome of IFD in children treated for hematological malignancies or undergoing HSCT in three major European pediatric cancer centers. Results: A total of 304 children (median age 6.0 years) who underwent 360 therapies (211 chemotherapy treatments, 138 allogeneic HSCTs and/or 11 investigational chemotherapeutic treatments) were included in the analysis. Nineteen children developed proven/probable IFD, mostly due to Aspergillus (n = 10) and Candida spp. (n = 5), respectively. In patients receiving chemotherapy, 11 IFDs occurred, all during induction or re-induction therapy. None of these patients died due to IFD, whereas IFD was lethal in 3 of the 8 HSCT recipients with IFD. Significant differences among centers were observed with regard to the use of imaging diagnostics and the choice, initiation and duration of antifungal prophylaxis. Conclusion: This prospective multicenter study provides information on the current incidence and outcome of IFD in the real life setting. Practice variation between the centers may help to ultimately improve antifungal management in children at highest risk for IFDs.

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Author:Thomas LehrnbecherORCiDGND, Stefan Schöning, Fiona Poyer, Jamina Georg, Andreas BeckerGND, Kathrin Gordon, Andishe AttarbaschiORCiDGND, Andreas Hermann GrollORCiD
URN:urn:nbn:de:hebis:30:3-503683
DOI:https://doi.org/10.3389/fmicb.2019.00681
ISSN:1664-302X
Pubmed Id:https://pubmed.ncbi.nlm.nih.gov/31040830
Parent Title (English):Frontiers in microbiology
Publisher:Frontiers Media
Place of publication:Lausanne
Contributor(s):Saad J. Taj-Aldeen
Document Type:Article
Language:English
Year of Completion:2019
Date of first Publication:2019/04/16
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2019/06/17
Tag:antifungal therapy; child; hematopoietic stem cell transplantation; invasive fungal disease; leukemia
Volume:10
Issue:Art. 681
Page Number:9
First Page:1
Last Page:9
Note:
Copyright © 2019 Lehrnbecher, Schöning, Poyer, Georg, Becker, Gordon, Attarbaschi and Groll. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
HeBIS-PPN:45076978X
Institutes:Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Sammlungen:Universitätspublikationen
Open-Access-Publikationsfonds:Medizin
Licence (German):License LogoCreative Commons - Namensnennung 4.0