Clinical Characteristics of Invasive Fungal Infections in Pediatric Oncology Patients With Solid Tumors

Ruijters, V J; Oosterom, Natanja; Perk, M. E. Madeleine van der; Wolfs, Tom F. W.; Meijer, Annelot J. M.; Heuvel‐Eibrink, Marry M. van den; Grotel, Martine van

doi:10.1097/mph.0000000000001761

Cited by 5 publications

(6 citation statements)

References 19 publications

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“…The true prevalence of invasive fungal disease (IFD) in children with solid tumors remains underexplored, as highlighted by recent studies by Ruijters et al. ( 3 , 4 ). Additionally, discussions of IFD cases in the context of CNS tumors are often limited to scenarios involving autologous stem cell transplantation (ASCT) ( 14 ).…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, it is well established that patients with hematologic malignancies and those undergoing allogeneic bone marrow transplantation have a high risk of developing infection and an indication of primary prophylaxis ( 1 , 2 ). Few studies describe the incidence of these diseases in patients with solid tumors ( 3 , 4 ) and there is an absence of information regarding pediatric patients with central nervous system (CNS) tumors. Considering other vulnerability factors to infections such as prolonged neutropenia, central venous catheter use, corticosteroid administration, cytotoxic chemotherapy, surgical interventions, and individual comorbidities ( 2 , 5 ), this study aims to assess the incidence of IFD in pediatric CNS tumor patients.…”

Section: Introductionmentioning

confidence: 99%

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Invasive fungal infections in pediatric patients with central nervous system tumors: novel insights for prophylactic treatments?

Dassi,

Cappellano,

Silva

et al. 2023

Front. Oncol.

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Background and aimsInvasive fungal disease (IFD) poses significant morbidity and mortality risks, especially in pediatric patients with neoplastic diseases. However, there is a notable lack of data concerning patients with central nervous system (CNS) tumors. Considering vulnerability factors to infections such as neutropenia, corticosteroids, chemotherapy, surgical interventions, and others, this study aims to evaluate the incidence of IFD in pediatric patients with CNS tumors and determine appropriate indications for prophylactic measures. This is a single-center, retrospective study conducted between 2011 and 2022 at the Pediatric Institute of Oncology (IOP-GRAACC-UNIFESP).ResultsA total of 38 cases of IFD were diagnosed in 818 children with CNS malignancies (4,6%). The mean age was 3.5 years (0.4-28y), with 22 (57.9%) male patients. Embryonal tumors (18/38, 47.3%) were the most prevalent CNS tumors, followed by low-grade gliomas (13/38, 34.2%). All episodes met the EORTC IFD criteria, and 36/38 (94.7%) were proven. Invasive yeast infections (33/36, 91.6%), predominantly Candida (30/33, 90.9%), were the most common diagnosis. In total, 25 patients (25/38, 65.8%) were receiving chemotherapy, with 13 of them having embryonal tumors. A total of 11 infants were in the Head Start scheme, resulting in a high prevalence of IFD in these group of patients (11/58, 18.9%). In total, 13 (13/38, 34.2%) patients underwent neurosurgery, mostly ventricular-peritoneal shunts revisions (10/13, 76.9%). Nine (9/38, 23.7%) were with prolonged use of corticosteroids, eight of them associated with neurosurgery.ConclusionRoutine systemic antifungal prophylaxis based solely on diagnosis is not recommended for low-risk cases. Evaluating patient- and treatment-specific risk factors is crucial in infants undergoing high-dose chemotherapy with expected neutropenia and in patients requiring prolonged corticosteroid therapy alongside neurosurgical procedures.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Invasive fungal infections in pediatric patients with central nervous system tumors: novel insights for prophylactic treatments?

Dassi,

Cappellano,

Silva

et al. 2023

Front. Oncol.

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“…Routine prophylaxis is not recommended 6,12 . Given significant diversity between treatment regimens, duration, and intensity of therapy for solid malignancies, risk of IFD is likely to vary between patient groups, though risk differences are not well understood 13 . The aim of this study was to document the prevalence, risk factors, microbiology, and outcomes for IFD in children with solid tumors 2 …”

Section: Introductionmentioning

confidence: 99%

Invasive fungal disease in children with solid tumors: An Australian multicenter 10‐year review

Jain,

Ryan,

Haeusler

et al. 2024

Pediatric Blood & Cancer

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Invasive fungal disease (IFD) occurs less frequently during treatment for solid compared to hematological malignancies in children, and risk groups are poorly defined. Retrospective national multicenter cohort data (2004–2013) were analyzed to document prevalence, clinical characteristics, and microbiology of IFD. Amongst 2067 children treated for solid malignancy, IFD prevalence was 1.9% overall and 1.4% for proven/probable IFD. Of all IFD episodes, 42.5% occurred in patients with neuroblastoma (prevalence 7.0%). Candida species comprised 54.8% of implicated pathogens in proven/probable IFD. In children with solid tumors, IFD is rare, and predominantly caused by yeasts.Routine prophylaxis may not be warranted.

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“…[3][4][5] The infection rate of ICs in patients with solid tumors continues to increase due to a more active multidrug chemotherapy scheme, increased use of antibiotics and use of high-dose immunosuppressants. [6][7][8] According to research reports from different cohorts of solid tumor patients, the invasive candidiasis infection rate of solid tumor patients ranges from 1.3% to 38.0%. 6 In patients with solid tumors, immune deficiency and disruption of gastrointestinal mucosal integrity are the reasons for the increased risk of invasive candidiasis infection.…”

Section: Introductionmentioning

confidence: 99%

“…[6][7][8] According to research reports from different cohorts of solid tumor patients, the invasive candidiasis infection rate of solid tumor patients ranges from 1.3% to 38.0%. 6 In patients with solid tumors, immune deficiency and disruption of gastrointestinal mucosal integrity are the reasons for the increased risk of invasive candidiasis infection. 9 In healthy individuals, candida and other microorganisms mainly play physiological functions and contribute to individual homeostasis, however, in patients with solid tumors, candida and other microorganisms play different roles and may play a role in promoting the progression of solid tumors.…”

Section: Introductionmentioning

confidence: 99%

Invasive Candidiasis in Patients with Solid Tumors: A Single-Center Retrospective Study

Bai¹,

Luo²

2023

IJGM

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Background Invasive candidiasis (ICs) is one of the common causes of death in patients with solid tumors. However, studies on the clinical characteristics of ICs with solid tumors are limited. Methods The purpose of this study was to retrospectively analyse the clinical characteristics, laboratory results and risk factor prediction of inpatients with ICs and solid tumors. We reviewed the clinical data and candida specimen information of hospitalized patients diagnosed with solid tumors combined with ICs at the First Hospital of China Medical University from January 2016 to December 2020. Multivariate logistic regression analysis was used to assess the prognostic factors associated with mortality in these patients. Results A total of 243 ICs patients with solid tumors were included in this study. The average ± SD age was 62.8 ± 11.7 (range: 27–93 years old), of which nearly 41% were ≥ 65 years old (99/243, 40.7%), and most were male (162/243, 66.6%). Most patients had malignant tumors of the digestive system. The most common candida was Candida parapsilosis (101/243, 41.5%), followed by Candida guilliermondii (83/243, 34.1%), Candida albicans (32/243, 13.1%), Candida glabrata (17/243, 6.9%), Candida tropicalis (7/243, 2.8%) and Candida krusei (3/243, 1.2%). Multivariate logistic regression analysis showed that the length of stay in the ICU, urinary catheter, total parenteral nutrition, stay in the ICU, renal failure and neutrophil count were prognostic factors related to death. Conclusion In this study, based on the clinical data of solid tumor patients with ICs in the past 5 years, the results showed that the length of stay in the ICU, urinary catheter, total parenteral nutrition, stay in the ICU, renal failure and neutrophil count were identified as the main prognostic factors. This study can be used to help clinicians carry out early intervention for high-risk patients.

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Clinical Characteristics of Invasive Fungal Infections in Pediatric Oncology Patients With Solid Tumors

Cited by 5 publications

References 19 publications

Invasive fungal infections in pediatric patients with central nervous system tumors: novel insights for prophylactic treatments?

Invasive fungal infections in pediatric patients with central nervous system tumors: novel insights for prophylactic treatments?

Invasive fungal disease in children with solid tumors: An Australian multicenter 10‐year review

Invasive Candidiasis in Patients with Solid Tumors: A Single-Center Retrospective Study

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