Invasive aspergillosis in children with acute leukemia at a resource-limited oncology center.
J Pediatr Hematol Oncol
; 37(1): e1-5, 2015 Jan.
Article
in En
| MEDLINE
| ID: mdl-24686246
ABSTRACT
BACKGROUND:
Invasive aspergillosis (IA) is one of the most feared complications in patients with hematologic malignancies because it is associated with high morbidity and mortality, and significantly compromises antileukemia therapy.OBJECTIVES:
Analyze all patients with acute leukemia and IA of less than 18 years of age, diagnosed between January 1996 and December 2011. MATERIALS ANDMETHODS:
Cases were identified from the pediatric database for demographic details, disease characteristics, and IA-related data.RESULTS:
Among 356 patients with acute leukemia, 34 were identified to have proven/probable IA (5/29) with a relative incidence of 9% (28/310) and 13% (6/46) among acute lymphoblastic leukemia (ALL) and acute myeloid leukemia, respectively. Incidence of IA was significantly higher after 2004 especially among ALL patients; older patients with hyperglycemia and high-risk disease were more predisposed. None of the risk factors or type of antifungal treatment predicted mortality. The 120-day aspergillus-attributable mortality rate was 14.7%. IA led to a median of 17 days (2 to 44 d) of additional hospital stay and contributed to delay or reduction in planned chemotherapy in 30/34 patients.CONCLUSIONS:
An increasing trend in incidence of IA was observed during the latter half of study period. Early empiric therapy led to modest aspergillus-free survival. Clinical and financial implications of IA mandate review of institutional antifungal prophylaxis policy especially in selected ALL patients during induction.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Aspergillosis
/
Leukemia, Myeloid, Acute
/
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Type of study:
Incidence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adolescent
/
Child
/
Child, preschool
/
Female
/
Humans
/
Male
Language:
En
Journal:
J Pediatr Hematol Oncol
Journal subject:
HEMATOLOGIA
/
NEOPLASIAS
/
PEDIATRIA
Year:
2015
Type:
Article