Improvement in the Outcome of Invasive Aspergillosis in a Pediatric Hematology Department: A 10-Year Review

J Pediatr Hematol Oncol. 2015 Oct;37(7):560-5. doi: 10.1097/MPH.0000000000000389.

Abstract

Background: Invasive aspergillosis (IA) is associated with a high mortality rate despite the introduction of new antifungal agents. Several therapeutic strategies have been proposed to improve mortality rates in IA, including combination of drugs.

Methods: Here, we report the outcome of treatments based on a combination of antifungal agents on IA, including voriconazole and liposomal amphotericin B, in a pediatric population from 2001 to 2010. Our population included children with diverse hematological diseases or with bone marrow transplantation.

Results: Over a 10-year period, we diagnosed 19 cases (2,8%) of invasive pulmonary aspergillosis with an overall survival rate of 58%.

Conclusion: Compared with the previous study conducted from 1986 to 2000, the overall survival rate (bone marrow transplantation excluded) greatly improved (12.5% to 58%), especially for patients treated for acute leukemia.

MeSH terms

  • Adolescent
  • Antifungal Agents / therapeutic use*
  • Antineoplastic Agents / adverse effects
  • Child
  • Child, Preschool
  • Female
  • Hematology / statistics & numerical data
  • Hematopoietic Stem Cell Transplantation / adverse effects
  • Humans
  • Immunocompromised Host
  • Infant
  • Invasive Pulmonary Aspergillosis / drug therapy*
  • Invasive Pulmonary Aspergillosis / immunology
  • Invasive Pulmonary Aspergillosis / mortality*
  • Leukemia / complications
  • Leukemia / drug therapy
  • Male
  • Pediatrics / statistics & numerical data
  • Retrospective Studies

Substances

  • Antifungal Agents
  • Antineoplastic Agents