Utility of Fungal Cell Markers in Pediatric Bone Marrow Transplant Recipients for Screening and Diagnosis of Invasive Fungal Infections

Abstract

Invasive fungal disease (IFD) is a significant contributor to morbidity and mortality in pediatric patients undergoing hematopoietic stem cell transplantation (HSCT). Early detection and timely initiation of antifungal therapy is important for improved outcome, but diagnosis remains difficult, especially when relying on conventional microbiology methods such as culture and microscopy. Data on the use of fungal biomarkers for screening and diagnosis of IFD in HSCT pediatric patients are limited, precluding the development of specific guidelines in this population. In this review, we have summarized available literature on kinetics, diagnostic and prognostic performance, and limitations of fungal biomarkers for screening and diagnosis of IFD in pediatric HSCT recipients to help guide their use and interpretation. Keywords β-D-glucan; galactomannan; invasive fungal disease; pediatric bone marrow transplant recipients