Role of Management Strategies in Reducing Mortality From Invasive Fungal Disease in Children With Cancer or Receiving Hemopoietic Stem Cell Transplant

Abstract

New management strategies resulted in a better prognosis of IFD in children with cancer or hemopoietic stem cell transplant. A diagnostic-driven approach was not associated with an increase in mortality.

A Prospective, International Cohort Study of Invasive Mold Infections in Children

“…Pediatric Invasive Mold Infections differences in global treatment success, progression-free survival, or mortality when comparing patients with different IMI types, but small numbers of patients with mucormycosis or other IMIs limit conclusions regarding outcome by subtype. The 12-week mortality rate of 30% in our cohort is similar to the 31% 12-week mortality rates from recent single-center cohort studies of IMIs in children with cancer or receiving HSCT [5,24]. The long-term mortality rate reported for one of these studies was much higher at 73%, and prior pediatric cohort studies, primarily focusing on IA, have reported similarly poor long-term mortality rates, ranging from 50% to 88% [3-5, 7, 25, 26].…”

Risk factors associated with development and mortality by invasive fungal diseases in pediatric allogeneic stem cell transplantation. A pediatric subgroup analysis of data from a prospective study of the Gruppo Italiano Trapianto di Midollo Osseo (GITMO)

“…This rate is lower than that reported in other pediatric series, but not too different from the most recent one [2]. This high proportion of proven/probable infections could be due to the more aggressive diagnostic protocols recently adopted also in pediatrics [12]. Noteworthy IFD were mainly observed in late post HSCT periods: 27% of cases in the early (days 1-40), 30% in the late (days 41-100) and 42% very late (days 101-365) post-HSCT phases (Table 1).…”

Epidemiology of invasive fungal diseases in children with solid tumours undergoing autologous haematopoietic stem cell transplantation: a 10‐year experience in a tertiary Italian centre

“…Further CT scan, ultrasound or magnetic resonance imaging were performed if needed according to clinical conditions. No empirical antifungal therapy was administered unless the patient was rapidly worsening, pending results of diagnostic investigations …”