Conclusions
Host factors, like neutropenia, relapse of disease, and hematologic malignancies, are determinant in the survival times of children affected with IFD. Pulmonary fungal infections, most caused by filamentous fungi, are also responsible for shortening survival times in these patients. Fungemia, most caused by Candida species, seems to lead to a better survival. Fluconazole prophylaxis does not appear to affect the hazards of death from IFD.
  1. Mor M, Gilad G, Kornreich L, Fisher S, Yaniv I, Levy I. Invasive fungal infections in pediatric oncology. Pediatr Blood Cancer. 2011;56(7):1092-1097. doi:10.1002/pbc.23005
  2. Gokcebay DG, Yarali N, Isik P, et al. Candida Associated Bloodstream Infections in Pediatric Hematology Patients: A Single Center Experience. Mediterr J Hematol Infect Dis. 2016;8(1):e2016018. doi:10.4084/MJHID.2016.018
  3. Morris SK, Allen UD, Gupta S, Richardson SE. Breakthrough filamentous fungal infections in pediatric hematopoetic stem cell transplant and oncology patients receiving caspofungin. Can J Infect Dis Med Microbiol. 2012;23(4):179-182. doi:10.1155/2012/957973
  4. Donnelly JP, Chen SC, Kauffman CA, Steinbach WJ, Baddley JW, Verweij PE, et al. Revision and Update of the Consensus Definitions of Invasive Fungal Disease From the European Organization for Research and Treatment of Cancer and the Mycoses Study Group Education and Research Consortium. Clin Infect Dis. 2020;71(6):1367-1376. doi: 10.1093/cid/ciz1008. PMID: 31802125
  5. Karimi A, Delpisheh A, Sayehmiri K. Application of accelerated failure time models for breast cancer patients’ survival in Kurdistan Province of Iran. J Cancer Res Ther. 2016;12(3):1184-1188. doi: 10.4103/0973-1482.168966. PMID: 28054533
  6. Bhatt VR, Viola GM, Ferrajoli A. Invasive fungal infections in acute leukemia. Ther Adv Hematol. 2011;2(4):231-247. doi:10.1177/2040620711410098
  7. Castagnola E, Cesaro S, Giacchino M, et al. Fungal infections in children with cancer: a prospective, multicenter surveillance study. Pediatr Infect Dis J. 2006;25(7):634-639. doi:10.1097/01.inf.0000220256.69385.2e
  8. Scorzoni L, de Paula E Silva AC, Marcos CM, et al. Antifungal Therapy: New Advances in the Understanding and Treatment of Mycosis. Front Microbiol. 2017;8:36. doi:10.3389/fmicb.2017.00036
  9. Kradin RL, Mark EJ. The pathology of pulmonary disorders due to Aspergillus spp. Arch Pathol Lab Med. 2008 Apr;132(4):606-14. doi: 10.1043/1543-2165(2008)132[606:TPOPDD]2.0.CO;2. PMID: 18384212
  10. Dragonetti G, Criscuolo M, Fianchi L, Pagano L. Invasive aspergillosis in acute myeloid leukemia: Are we making progress in reducing mortality? Med Mycol. 2017 Jan 1;55(1):82-86. doi: 10.1093/mmy/myw114. Epub 2016 Dec 2. PMID: 27915304
  11. Petrikkos G, Drogari-Apiranthitou M. Zygomycosis in Immunocompromised non-Haematological Patients. Mediterr J Hematol Infect Dis. 2011;3(1):e2011012. doi:10.4084/MJHID.2011.012
  12. Nucci M, Anaissie E. Fusarium infections in immunocompromised patients. Clin Microbiol Rev. 2007;20(4):695-704. doi:10.1128/CMR.00014-07
  13. Fernández-Ruiz M, Guinea J, Puig-Asensio M, Zaragoza Ó, Almirante B, Cuenca-Estrella M, et al; CANDIPOP Project; GEIH-GEMICOMED (SEIMC) and REIPI. Fungemia due to rare opportunistic yeasts: data from a population-based surveillance in Spain. Med Mycol. 2017;55(2):125-136. doi: 10.1093/mmy/myw055
  14. Bhatt VR, Viola GM, Ferrajoli A. Invasive fungal infections in acute leukemia. Therapeutic Advances in Hematology. 2011:231-247. doi:10.1177/2040620711410098
  15. Wiederhold NP, Lewis RE, Kontoyiannis DP. Invasive aspergillosis in patients with hematologic malignancies. Pharmacotherapy. 2003;23(12):1592-610. doi: 10.1592/phco.23.15.1592.31965. PMID: 14695039
  16. Medinger M, Lengerke C, Passweg J. Novel therapeutic options in Acute Myeloid Leukemia. Leuk Res Rep. 2016;6:39-49. doi:10.1016/j.lrr.2016.09.001
Legend of figure 1:
Figure 1. Kaplan Meier survival curves in IFI, for the diagnoses of leukemia, presence of neutropenia, pulmonary fungal infections and fungemia by Candida species. P-values refer to the log rank test.