Invasive fungal infections in children and adolescents after hematopoietic stem cell transplantation
Journal Title: Postępy Nauk Medycznych - Year 2015, Vol 28, Issue 6
Abstract
Introduction. Infections are the main cause of morbidity and mortality in children with cancer or undergoing stem cell transplantation. Patients undergoing hematopoietic stem cell transplantation (HSCT) are at particularly high risk of invasive fungal infections (IFI). Aim. The aim of this study was the analysis of incidence and outcome of fungal infections in five Polish centers of pediatric hematopoietic stem cell transplantation (HSCT) units of Polish Pediatric Group for Hematopoietic Stem Cell Transplantation over a period of 24 months. Material and methods. The study was performed within the project “Infections in Polish pediatric hematology, oncology and stem cell transplant setting 2013 (iPhot-13)”. During this period a total number of 308 HSCTs were performed in participating centers. Results. Median time from HSCT to development of IFI was 1 month. The incidence of patients with at least one episode of fungal infection was 27.3% among children undergoing HSCT. The incidence of IFI was prominently high in acute lymphoblastic leukemia (ALL; 31.3%) and acute myeloblastic leukemia patients (AML; 44.7%). With respect to level of diagnosis the incidence was: 3.6% (n = 11) for proven, 9.4% (n = 29) probable and 14.3% (n = 44) possible IFI. 100-day survival from IFI was 75%, and 92.3, 61.5, and 82.6% for proven, probable, and possible IFI, respectively. No differences were found in outcome from IFI between auto- vs. allo-HSCT patients, as well as between ALL vs. AML. Conclusions. Emerging data from Polish pediatric hematopoietic stem cell transplant centers indicate high incidence of infectious complications in pediatric population. The incidence of IFI after HSCT, and particularly in ALL and AML is much higher than it was recently anticipated. The rate of survival after IFI in HSCT setting is 75%, what is comparable with the best results obtained worldwide.
Authors and Affiliations
Jan Styczyński, Karolina Siewiera, Krzysztof Czyżewski, Jowita Frączkiewicz, Ewa Gorczyńska, Alicja Chybicka, Olga Zając-Spychała, Jacek Wachowiak, Jolanta Goździk, Agnieszka Zaucha-Prażmo, Jerzy Kowalczyk, Mariusz Wysocki
Keywords
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- EP ID EP77399
- DOI 10.5604/08606196.1157749
- Views 237
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