Risks and outcomes of invasive fungal infections in pediatric allogeneic hematopoietic stem cell transplant recipients receiving fluconazole prophylaxis: a multicenter cohort study by the Turkish Pediatric Bone Marrow Transplantation Study Group

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dc.contributor.authorHazar, Volkan
dc.contributor.authorKarasu, Gulsun Tezcan
dc.contributor.authorUygun, Vedat
dc.contributor.authorOzturk, Gulyuz
dc.contributor.authorKilic, Suar Caki
dc.contributor.authorKupesiz, Alphan
dc.contributor.authorDaloglu, Hayriye
dc.contributor.authorAksoylar, Serap
dc.contributor.authorAtay, Didem
dc.contributor.authorInce, Elif Unal
dc.contributor.authorKarakukcu, Musa
dc.contributor.authorOzbek, Namik
dc.contributor.authorTayfun, Funda
dc.contributor.authorKansoy, Savas Comma
dc.contributor.authorOzyurek, Emel
dc.contributor.authorAkcay, Arzu
dc.contributor.authorGursel, Orhan
dc.contributor.authorHaskologlu, Sule
dc.contributor.authorKaya, Zuhre
dc.contributor.authorYilmaz, Sebnem
dc.contributor.authorTanyeli, Atila
dc.contributor.authorYesilipek, Akif
dc.date.accessioned2019-10-27T09:46:18Z
dc.date.available2019-10-27T09:46:18Z
dc.date.issued2019
dc.departmentEge Üniversitesien_US
dc.description.abstractInvasive fungal infections (IFIs) are a major cause of infection-related morbidity and mortality in patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT). Data from pediatric settings are scarce. To determine the incidence, risk factors and outcomes of IFIs in a 180-day period post-transplantation, 408 pediatric patients who underwent allogeneic HSCT were retrospectively analyzed. The study included only proven and probable IFIs. The cumulative incidences of IFI were 2.7%, 5.0%, and 6.5% at 30, 100, and 180 days post-transplantation, respectively. According to the multivariate analysis, the factors associated with increased IFI risk in the 180-day period post-HSCT were previous HSCT history (hazard ratio [HR], 4.57; 95% confidence interval [CI] 1.42-14.71; P =.011), use of anti-thymocyte globulin (ATG) (HR, 2.94; 95% CI 1.27-6.80; P =.012), grade III-IV acute graft-versus-host-disease (GVHD) (HR, 2.91; 95% CI 1.24-6.80; P =.014) and late or no lymphocyte engraftment (HR, 2.71; 95% CI 1.30-5.62; P =.007). CMV reactivation was marginally associated with an increased risk of IFI development (HR, 1.91; 95% CI 0.97-3.74; P =.063). IFI-related mortality was 1.5%, and case fatality rate was 27.0%. The close monitoring of IFIs in pediatric patients with severe acute GVHD who receive ATG during conditioning is critical to reduce morbidity and mortality after allogeneic HSCT, particularly among those with prior HSCT and no or late lymphocyte engraftment.en_US
dc.identifier.doi10.1093/mmy/myy015
dc.identifier.endpage170en_US
dc.identifier.issn1369-3786
dc.identifier.issn1460-2709
dc.identifier.issn1369-3786en_US
dc.identifier.issn1460-2709en_US
dc.identifier.issue2en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage161en_US
dc.identifier.urihttps://doi.org/10.1093/mmy/myy015
dc.identifier.urihttps://hdl.handle.net/11454/29258
dc.identifier.volume57en_US
dc.identifier.wosWOS:000462493400004en_US
dc.identifier.wosqualityQ1en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.language.isoenen_US
dc.publisherOxford Univ Pressen_US
dc.relation.ispartofMedical Mycologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectallogeneic hematopoietic stem cell transplantationen_US
dc.subjectinvasive fungal infectionsen_US
dc.subjectrisk factorsen_US
dc.subjectchildrenen_US
dc.titleRisks and outcomes of invasive fungal infections in pediatric allogeneic hematopoietic stem cell transplant recipients receiving fluconazole prophylaxis: a multicenter cohort study by the Turkish Pediatric Bone Marrow Transplantation Study Groupen_US
dc.typeArticleen_US

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