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Proven and probable invasive fungal infections in children with acute lymphoblastic leukaemia: results from an university hospital, 2005–2013
Author(s) -
Sahbudak Bal Zumrut,
Yilmaz Karapinar Deniz,
Karadas Nihal,
Sen Semra,
Onder Sivis Zuhal,
Akinci Ayse B.,
Balkan Can,
Kavakli Kaan,
Vardar Fadil,
Aydinok Yesim
Publication year - 2015
Publication title -
mycoses
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.13
H-Index - 69
eISSN - 1439-0507
pISSN - 0933-7407
DOI - 10.1111/myc.12303
Subject(s) - neutropenia , medicine , incidence (geometry) , etiology , hematology , pediatrics , intensive care medicine , chemotherapy , physics , optics
Summary Despite improvements in diagnosis and treatment, invasive fungal infections ( IFI s) are still a major cause of morbidity and mortality in immunocompromised patients. The data on IFI among children with acute lymphoblastic leukaemia ( ALL ) are still scarce, and our aim was to estimate the risk, aetiology and outcome of proven and probable IFI s in children with ALL who did not receive primary prophylaxis over an 8‐year period. Between January 2005 and February 2013, 125 children who were treated for ALL at the Pediatric Hematology Department of the Medical School of Ege University were retrospectively reviewed. Proven and probable IFI s were defined according to revised definitions of the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group. The proven and probable IFI incidence was 30/125 (24%). Profound neutropenia was detected in 18 (60%) patients, and prolonged neutropenia was detected in 16 (53.3%) of the patients. The most isolated agents were non‐ albicans Candida spp. The crude and attributable mortality was 20% and 13.3% respectively. Profound neutropenia was associated with mortality ( P < 0.05). The younger patients were especially at risk for proven IFI . Prolonged neutropenia, to be in the induction phase of chemotherapy, and profound neutropenia were found to be the most common predisposing factors for IFI episodes.