Antifungal Chemoprophylaxis in Children and Adolescents with Haematological Malignancies and Following Allogeneic Haematopoietic Stem Cell Transplantation

Tragiannidis, Athanasios; Dokos, Charalampos; Lehrnbecher, Thomas; Groll, Andreas H.

doi:10.2165/11599810-000000000-00000

Cited by 52 publications

(39 citation statements)

References 124 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, this study only included patients with acute leukemia, non‐Hodgkin lymphoma, or who underwent HSCT, and thus exclusively represented a higher risk cohort, whereas children in our study encompassed a more complete spectrum of hematological malignancies and solid tumors. The mortality associated with invasive aspergillosis and invasive candidiasis in our cohort is also better than previously reported, which again may reflect our broader oncology and HSCT cohort, but also reflect developments in supportive care, and improved diagnostic and therapeutic strategies.…”

Section: Discussionsupporting

confidence: 60%

Epidemiology of invasive fungal infections in immunocompromised children; an Australian national 10‐year review

Bartlett

Cann

Yeoh

et al. 2018

Pediatric Blood & Cancer

View full text Add to dashboard Cite

Background A thorough understanding of local and contemporary invasive fungal infection (IFI) epidemiology in immunocompromised children is required to provide a rationale for targeted prevention and treatment strategies. Methods Retrospective data over 10 years from four tertiary pediatric oncology and hematopoietic stem cell transplant (HSCT) units across Australia were analyzed to report demographic, clinical, and mycological characteristics of IFI episodes, and crude IFI prevalence in select oncology/HSCT groups. Kaplan–Meier survival analyses were used to calculate 180‐day overall survival. Results A total of 337 IFI episodes occurred in 320 children, of which 149 (44.2%), 51 (15.1%), and 110 (32.6%) met a modified European Organization for Research and Treatment of Cancer (mEORTC) criteria for proven, probable, and possible IFI, respectively. There were a further 27 (8.0%) that met a “modified possible IFI” criteria. Median age at IFI diagnosis was 8.4 years. Crude mEORTC IFI prevalence in acute lymphoblastic leukemia, acute myeloid leukemia, solid tumor, and allogeneic HSCT cohorts was 10.6%, 28.2%, 4.4%, and 11.7%, respectively. Non‐Aspergillus species represented 48/102 (47.1%) molds identified, and non‐albicans Candida represented 66/93 (71.0%) yeasts identified. There were 56 deaths among 297 children who met mEORTC criteria, with 180‐day overall survival for proven, probable, and possible IFIs of 79.7%, 76.2%, and 84.4%, respectively. Conclusion Non‐Aspergillus molds and non‐albicans Candida contributed substantially to pediatric IFI in our study, with high IFI prevalence in leukemia and allogeneic HSCT cohorts. Inclusion of IFIs outside of European Organization for Research and Treatment of Cancer criteria revealed an IFI burden that would go otherwise unrecognized in published reports.

show abstract

Section: Discussionsupporting

confidence: 60%

Epidemiology of invasive fungal infections in immunocompromised children; an Australian national 10‐year review

Bartlett

Cann

Yeoh

et al. 2018

Pediatric Blood & Cancer

View full text Add to dashboard Cite

show abstract

“…52 Although this is the first detailed PK report with full concentration-time profiles of PSC in children younger than 13 years, an important limitation is the small number of included patients hampering broad scale correlation analysis looking for factors influencing PSC PK. A larger study is definitely an added value to further unravel the appropriate dosing regimen.…”

Section: Discussionmentioning

confidence: 98%

Pharmacokinetics of Posaconazole Oral Suspension in Children Dosed According to Body Surface Area

Vanstraelen

Coliţă

Bica

et al. 2016

Pediatric Infectious Disease Journal

View full text Add to dashboard Cite

show abstract

“…Patients in the DF group were overall younger than the non-DF group, were more likely to have high Karnofsky scores, and were less likely to have had a significant fungal infection prior to transplant. Younger age 14 , higher Karnofsky score 15 , and absence of fungal infections 16,17 have been associated with improved survival.…”

Section: Discussionmentioning

confidence: 99%

Defibrotide for Treatment of Severe Veno-Occlusive Disease in Pediatrics and Adults: An Exploratory Analysis Using Data from the Center for International Blood and Marrow Transplant Research

Strouse

Richardson

Prentice

et al. 2016

Biology of Blood and Marrow Transplantation

View full text Add to dashboard Cite

Veno-occlusive disease (VOD) is an early and serious complication of hematopoietic cell transplantation (HCT) that is associated with inferior survival, particularly when it is complicated by multi-organ failure (severe VOD). We evaluated the efficacy of defibrotide in the treatment of severe VOD using observational data from the Center for International Blood and Marrow Transplant Research (CIBMTR). Eight thousand three hundred forty-one patients treated by HCT between 2008 and 2011 were identified from the CIBMTR clinical database; 3.2% met criteria for VOD and 1.2% met criteria for severe VOD. Patients with a diagnosis of VOD as reported to the CIBMTR by their transplanting centers, who had no prior history of cirrhosis, and who had a maximum total bilirubin >2.0mg/dl by day +100 post-HCT were selected for study. Severe VOD was defined as VOD occurring in the setting of renal impairment requiring dialysis or any non-infectious pulmonary abnormality. Patients with severe VOD were divided into two groups for analysis: those treated with defibrotide (n=41) and those not treated with defibrotide (n=55). Patients in the non-defibrotide group were older, were more likely to be male, were more likely to have a history of previous fungal infection, and had a higher proportion of clinically significant pre-existing disease or organ impairment. Survival at day +100 was 39% (95% CI: 24.8–54.3%) in patients receiving defibrotide and 30.9% (95% CI: 19.5% – 43.6%) in those not receiving defibrotide. Resolution of VOD at day +100 was 51% in the defibrotide group, and 29% in the non-defibrotide group (difference 22.1%, 95% CI: 2.6% – 42%). The results of our study are consistent with previously reported experiences with defibrotide, confirm the poor outcome of this syndrome, and suggest defibrotide is effective in the treatment of severe VOD.

show abstract

Antifungal Chemoprophylaxis in Children and Adolescents with Haematological Malignancies and Following Allogeneic Haematopoietic Stem Cell Transplantation

Cited by 52 publications

References 124 publications

Epidemiology of invasive fungal infections in immunocompromised children; an Australian national 10‐year review

Epidemiology of invasive fungal infections in immunocompromised children; an Australian national 10‐year review

Pharmacokinetics of Posaconazole Oral Suspension in Children Dosed According to Body Surface Area

Defibrotide for Treatment of Severe Veno-Occlusive Disease in Pediatrics and Adults: An Exploratory Analysis Using Data from the Center for International Blood and Marrow Transplant Research

Contact Info

Product

Resources

About