Invasive fungal disease in children with acute myeloid leukaemia: An Australian multicentre 10‐year review
| العنوان: | Invasive fungal disease in children with acute myeloid leukaemia: An Australian multicentre 10‐year review |
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| المؤلفون: | Anne L. Ryan, Brendan McMullan, Megan P. Cann, Karin A Thursky, Gabrielle M Haeusler, Monica A. Slavin, Daniel K Yeoh, Julia E Clark, Rishi S. Kotecha, Christopher C Blyth, Andrew S. Moore, Adam W. Bartlett |
| المصدر: | Pediatric Blood & Cancer. 68 |
| بيانات النشر: | Wiley, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | medicine.medical_specialty, Chemotherapy, Antifungal Agents, Hematology, business.industry, medicine.medical_treatment, Australia, Context (language use), Leukemia, Myeloid, Acute, Oncology, Internal medicine, Pediatrics, Perinatology and Child Health, Epidemiology, Cohort, medicine, Humans, Child, business, Complication, Invasive Fungal Infections, Fluconazole, Survival analysis, Retrospective Studies, medicine.drug |
| الوصف: | Background Invasive fungal disease (IFD) is a common and important complication in children with acute myeloid leukaemia (AML). We describe the epidemiology of IFD in a large multicentre cohort of children with AML. Methods As part of the retrospective multicentre cohort TERIFIC (The Epidemiology and Risk factors for Invasive Fungal Infections in immunocompromised Children) study, proven/probable/possible IFD episodes occurring in children with primary or relapsed/refractory AML from 2003 to 2014 were analysed. Crude IFD prevalence, clinical characteristics, microbiology and treatment were assessed. Kaplan-Meier survival analysis was used to estimate 6-month survival. Results There were 66 IFD episodes diagnosed in 63 children with AML. The majority (75.8%) of episodes occurred in the context of primary AML therapy. During primary AML therapy, the overall prevalence was 20.7% (95% CI 15.7%-26.5%) for proven/probable/possible IFD and 10.3% (95% CI 6.7%-15.0%) for proven/probable IFD. Of primary AML patients, 8.2% had IFD diagnosed during the first cycle of chemotherapy. Amongst pathogens implicated in proven/probable IFD episodes, 74.4% were moulds, over a third (37.9%) of which were non-Aspergillus spp. Antifungal prophylaxis preceded 89.4% of IFD episodes, most commonly using fluconazole (50% of IFD episodes). All-cause mortality at 6 months from IFD diagnosis was 16.7% with IFD-related mortality of 7.6% (all in cases of proven IFD). Conclusions IFD is a common and serious complication during paediatric AML therapy. Mould infections, including non-Aspergillus spp. predominated in this cohort. A systematic approach to the identification of patients at risk, and a targeted prevention strategy for IFD is needed. |
| تدمد: | 1545-5017 1545-5009 |
| DOI: | 10.1002/pbc.29275 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b8ac193405adafe22fa8a73532990b84 https://doi.org/10.1002/pbc.29275 |
| Rights: | CLOSED |
| رقم الانضمام: | edsair.doi.dedup.....b8ac193405adafe22fa8a73532990b84 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15455017 15455009 |
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| DOI: | 10.1002/pbc.29275 |