BACKGROUND: Data on epidemiology and survival after fungal infections in patientswith cancer are primarily based on studies in adults, whereas few data areavailable on children.METHODS: A prospective, multicenter, 2-year surveillance of fungal infections in children receiving antineoplastic treatment was performed in 15 Italian centers. For each case, defined by means of EORTC-IFIG/NIAID-MSG, information wascollected on age, phase of treatment, presence of neutropenia or lymphocytopenia,administration of antifungal drugs and survival.RESULTS: Ninety-six episodes (42 proven [19 fungemias, 23 deep tissueinfections], 17 probable and 37 possible invasive mycoses) were reported. Most ofthem (73%) followed aggressive chemotherapy, 21% allogeneic hematopoietic stemcell transplantation and only 6% moderately aggressive treatment. Neutropenia waspresent in 77% of the episodes, and it had a longer duration before deep tissuemycosis as compared with fungemia (P = 0.020). Lymphocytopenia was present in 75%of the episodes observed in nonneutropenic patients. As compared with childrenwith fungemia, patients with probable invasive mycoses had a 25.7-fold increased risk of death, whereas it was 7.7-fold greater in children with possible invasivemycoses and 5-fold higher in those with proven deep tissue infection (P = 0.004).The risk of death was also 3.8-fold higher in patients already receivingantifungals at the time of diagnosis of infection as compared with those notreceiving antimycotic drugs.CONCLUSIONS: In children with cancer, aggressive antineoplastic treatment, severeand longlasting neutropenia and lymphocytopenia are associated with fungalinfections. These features as the clinical pictures are similar to those reportedin adults, but in children, the overall and the infection-specific (fungemia ormycosis with deep tissue infection) mortalities are lower.
|Titolo:||Fungal infections in children with cancer - A prospective, multicenter surveillance study|
|Autori interni:||CESARO, SIMONE|
|Data di pubblicazione:||2006|
|Rivista:||THE PEDIATRIC INFECTIOUS DISEASE JOURNAL|
|Appare nelle tipologie:||01.01 Articolo in Rivista|