Invasive fungal infections in pediatric leukemia patients receiving fluconazole prophylaxis

Kaya, Zühre; Gürsel, Türkiz; Koçak, Ülker; Aral, Yusuf Ziya; Kalkancı, Ayşe; Albayrak, Meryem

doi:10.1002/pbc.21868

Cited by 65 publications

(55 citation statements)

References 41 publications

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“…The duration of severe neutropenia has been reported to be a risk factor for IFI, with >7 days of severe neutropenia defining intermediate risk and >21 days defining high risk [4,5,6,7,8,9,10,36]. In our study, more than half of the patients recovered ANC in less than 9 days (42/64, 66%) and the vast majority of patients recovered in less than 13 days (57/64, 89%) after HiDAC consolidation.…”

Section: Discussionmentioning

confidence: 99%

“…A longer neutropenia duration after chemotherapy is one of the main risk factors for developing IFI [4,5,6,7,8,9,10,11]. Neutropenia duration is mainly affected by the intensity of the chemotherapy regimen as well as by the patient’s age, bone marrow (BM) reserve, response to chemotherapy, or the use of granulocyte colony-stimulating factors (G-CSF).…”

Section: Introductionmentioning

confidence: 99%

“…Patients with AML receiving induction or reinduction or undergoing allogeneic hematopoietic cell transplantation experience longer, more severe neutropenia. This, along with other factors, puts these patients at a higher risk for developing IFI [1,2,3,4,5,6,7,8,9,10,12,13]. …”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Acute Myelogenous Leukemia Patients Are at Low Risk for Invasive Fungal Infections after High-Dose Cytarabine Consolidations and Thus Do Not Require Prophylaxis

Lewis¹,

Hall

Eisa³

et al. 2010

Acta Haematol

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We evaluated the frequency of invasive fungal infections (IFI), the frequency of empirical antifungal use (EAFU), and the efficacy of fluconazole prophylaxis on IFI and EAFU after high-dose cytarabine (HiDAC) consolidations. Twenty-seven acute myelogenous leukemia patients in their first complete remission received 76 cycles of HiDAC (median cycle: n = 3). Fluconazole prophylaxis was administered following 44 cycles (fluconazole group) and not given in 32 cycles (control group). IFI (2 episodes) + EAFU (11 episodes) was observed in 13 of 76 cycles (17%); there was no difference between the fluconazole group and the control group (p = 0.469). Neutropenia duration was <13 days in 89% of the 76 cycles and was similar in the fluconazole and control groups (p = 0.845). Neutropenic fever was observed in 34 of the 76 cycles (45%) and was similar in the fluconazole group and the control group (p = 0.43). Although HiDAC cycle 1 was associated with a shorter neutropenia duration, there was no association between HiDAC cycle numbers and neutropenic fever or IFI + EAFU. HiDAC consolidations resulted in a high rate of neutropenic fever, the lack of an appreciable benefit from EAFU, and rare IFI. Most likely because of the low incidence of IFI, use of fluconazole or another antifungal is not warranted in this setting.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Acute Myelogenous Leukemia Patients Are at Low Risk for Invasive Fungal Infections after High-Dose Cytarabine Consolidations and Thus Do Not Require Prophylaxis

Lewis¹,

Hall

Eisa³

et al. 2010

Acta Haematol

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“…The estimated incidence in children with high-risk AML of severe bacterial infections is 50-60% and the estimated incidence of invasive fungal infections is 7.0-12.5% [103][104][105]. The improved outcome in children with AML over the last 10 years may be associated to better supportive care strategies.…”

Section: Supportive Treatmentmentioning

confidence: 99%

Acute Myeloid Leukemia in Pediatric Patients: A Review About Current Diagnostic and Treatment Approaches

Derwich¹,

Mitkowski²,

J³

2018

Myeloid Leukemia

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Acute leukemia is the most common childhood malignancy, accounting for almost 35% of all childhood cancers. Acute myeloid leukemia (AML) represents 15-20% of pediatric acute leukemia. Majority of AML cases appear de novo, however a minority of cases can present as a secondary malignancy. AML is a highly heterogeneous disease and its diagnosis involves a combination of diagnostic analyses including morphology, immunophenotyping, cytochemistry, and leukemic blasts derived from peripheral blood or bone marrow demonstrating cytogenic and molecular characteristics. Through the identification of recurrent genetic mutations, it has been made possible to refine individual prognosis and guide therapeutic management. The current survival rate of children with AML is approximately 70%. The standard therapeutic regimen is a combination of cytarabine-and anthracycline-based regimens with allogenic stem cell transplantation in appropriate patients. Relapse in pediatric patients suffering from AML occurs in approximately 30% of cases, whereas death occurs in 5-10% of patients as a result of disease complications or chemotherapeutic side effects. In understanding the genetic basis of AML, targeted therapies will have the ability to reduce treatment-related morbidity and mortality. Here, we provide a comprehensive review of AML, its biology, diagnosis and therapeutic management in pediatric patients.

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“…AML tedavisinde kemoterapi esnasında ve sonrasında hastaların destek tedavileri önem arz etmektedir. Yapılan çalışmalar akut miyeloid lösemi hastalarında şiddetli bakteriel sepsis riskinin %50-60 ve fungal enfeksiyon riskinin %7-13 olduğunu göstermiştir 23,24 . Trombosit sayımı 10.000/dL ve altında olanlarda semptomatik anemi ya da ek risk faktörü olmasa bile, destekte bulunulması önerilmektedir 1 .…”

Section: Aml Tedavisinde Amaç Hastaya Verilen En Az Toksisite Ile Tamunclassified

Çocukluk Çağında Akut Myeloid Lösemi

Yöntem¹,

Bayram²

2018

Arşiv Kaynak Tarama Dergisi

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Acute leukemia is basically divided into acute lymphoblastic leukemia and acute myeloid leukemia (AML). About 15-20% of childhood leukemia is caused by AML. AML is classified according to morphological, cytochemical and immunophenotypic characteristics. AML patients may present with various clinical signs and symptoms due to leukemic cell infiltration. Age, gender, race, structural features of the patient and cytogenetic abnormalities are important factors affecting prognosis in AML. The goal in the treatment of AML is to provide complete remission with the least toxicity given to the patient and to maintain this remission. In this study, etiology, classification, clinical features, prognosis and treatment strategies of childhood AML were investigated.

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Invasive fungal infections in pediatric leukemia patients receiving fluconazole prophylaxis

Abstract: Our results indicate that AFP with fluconazole and early empirical antifungal therapy may be effective in reducing the incidence and mortality of IFI in children with acute leukemia.

Cited by 65 publications

References 41 publications

Acute Myelogenous Leukemia Patients Are at Low Risk for Invasive Fungal Infections after High-Dose Cytarabine Consolidations and Thus Do Not Require Prophylaxis

Acute Myelogenous Leukemia Patients Are at Low Risk for Invasive Fungal Infections after High-Dose Cytarabine Consolidations and Thus Do Not Require Prophylaxis

Acute Myeloid Leukemia in Pediatric Patients: A Review About Current Diagnostic and Treatment Approaches

Çocukluk Çağında Akut Myeloid Lösemi

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