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Fungal infections in hematopoietic stem cell transplantation in children at a pediatric children’s hospital in Argentina
Author(s) -
Gomez Sergio M.,
Caniza Miguela,
Fynn Alicira,
Vescina Cecilia,
Ruiz Claudia,
Iglesias Daniela,
Sosa Fernanda,
Sung Lillian
Publication year - 2018
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.12913
Subject(s) - medicine , hematopoietic stem cell transplantation , incidence (geometry) , retrospective cohort study , aspergillosis , cumulative incidence , complication , pediatrics , transplantation , hematopoietic stem cell , stem cell , haematopoiesis , immunology , physics , biology , optics , genetics
Our primary objective was to describe the incidence of proven or probable invasive fungal infections ( IFI s), a devastating complication of hematopoietic stem cell transplant ( HSCT ), in HCST in a middle‐income country. Secondary objectives were to describe factors associated with IFI s and outcomes. In this single center retrospective study, pediatric patients who underwent a first allogeneic or autologous HSCT from 1998 to 2016 were included. Of the 251 HSCT recipients: 143 transplants were allogeneic and 108 were autologous. Overall, 23 (9%) experienced an IFI , mostly due to yeasts (83%). IFI s were more common in allogeneic HSCT (18/143, 13%) than in autologous HSCT (5/108, 5%; P = .045). Of the 23 patients with IFI s, 14 (61%) died, but only 1 directly from IFI (pulmonary aspergillosis). Overall survival at 3 years was 0.42 ± 0.11 in patients with IFI s and 0.60 ± 0.37 in those without IFI s ( P = .049). In Argentina, IFI s during HSCT are common. Recipients of allogeneic HSCT are at higher risk, and IFI is associated with reduced overall survival. Future work should focus on interventions to reduce and improve IFI outcomes in children undergoing transplants in low‐ and middle‐income countries.