Secondary antifungal prophylaxis in pediatric hematopoietic stem cell transplants

J Pediatr Hematol Oncol. 2015 Jan;37(1):e19-22. doi: 10.1097/MPH.0000000000000175.

Abstract

Invasive fungal infections (IFIs) constitute a leading cause of morbidity and infection-related mortality among hematopoietic stem cell transplant (HSCT) recipients. With the use of secondary prophylaxis, a history of IFI is not an absolute contraindication to allo-HSCT. However, still, IFI recurrence remains a risk factor for transplant-related mortality. In this study, of the 105 children undergoing HSCT between April 2010 and February 2013, 10 patients who had IFI history before transplantation and had undergone allo-HSCT were evaluated retrospectively to investigate results of secondary prophylaxis. In conclusion, our study shows that amphotericin B and caspofungin was successful as secondary antifungal prophylaxis agents with no relapse of IFI. In addition, after engraftment, secondary prophylaxis was continued with voriconazole orally in 4 patients that yielded good results.

MeSH terms

  • Adolescent
  • Amphotericin B / therapeutic use
  • Antifungal Agents / therapeutic use*
  • Caspofungin
  • Child
  • Echinocandins / therapeutic use
  • Female
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Humans
  • Lipopeptides
  • Male
  • Mycoses / prevention & control*
  • Retrospective Studies

Substances

  • Antifungal Agents
  • Echinocandins
  • Lipopeptides
  • Amphotericin B
  • Caspofungin