Population and Study Design
This retrospective observational study included children ≤ 21 years diagnosed at Texas Children’s Hospital (TCH) with ALL, AML, or lymphoma between 2006 and 2019, and who had a proven or probable IMI diagnosed between January 1, 2006 and June 30, 2020. Recipients of HSCT who developed IMI post-HSCT were excluded. The TCH antifungal algorithm was implemented in January 2016, and comparisons were made between time periods of January 2006 through December 2015, and January 2016 through June 2020. Potential cases were identified by the TCH Health Information Management (HIM) team using ICD9 codes that included ALL and AML (ICD9 204-208), lymphoma (ICD9 200-202), and fungal disease (ICD9 117-118, 421, 518.89, 530.19, 730.2, 739.19). The study was approved by the Baylor College of Medicine institutional review board.