Invasive Fungal Infections in Children With Acute Myeloid Leukemia: A Single-center Experience Over 19 Years

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dc.authorscopusid56088300100
dc.authorscopusid53163863600
dc.authorscopusid57222559973
dc.authorscopusid38061964200
dc.authorscopusid6507039290
dc.authorscopusid56088640300
dc.authorscopusid6701871501
dc.contributor.authorAvcu, G.
dc.contributor.authorKaradas, N.
dc.contributor.authorGoktepe, S.O.
dc.contributor.authorBal, Z.S.
dc.contributor.authorMetin, D.Y.
dc.contributor.authorPolat, S.H.
dc.contributor.authorAydinok, Y.
dc.date.accessioned2024-08-25T18:38:45Z
dc.date.available2024-08-25T18:38:45Z
dc.date.issued2023
dc.departmentEge Üniversitesien_US
dc.description.abstractObjective: Invasive fungal infections (IFIs) remain a significant cause of morbidity and mortality in children with acute myeloid leukemia (AML). This study aimed to evaluate the incidence, risk factors, etiology, and outcome of IFIs in children with AML and the effect of mold-active antifungal prophylaxis. Materials and Methods: We retrospectively reviewed pediatric patients treated for AML between January 2004 and December 2022. Proven, probable, or possible IFIs were defined using standardized definitions of the European Organization for the Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG) classification published at 2008. Results: A total of 298 febrile neutropenia episodes from 78 patients were evaluated. Proven, probable, and possible IFI rates were 3%, 2.6%, and 9.4%, respectively. Profound neutropenia was detected in 18 (58%) and prolonged neutropenia in 20 (64.5%) of the IFI episodes. Invasive aspergillosis accounted for the majority of IFI episodes; however, non-albicans Candida spp. were the most isolated pathogens in the proven group. Patients with relapsed AML were particularly at risk for the development of IFI (P=0.02). A significant decrease in IFI episodes was achieved with mold-active antifungal prophylaxis with voriconazole (P=0.01, odds ratio: 0.288, %95 CI:0.104-0.797). The overall mortality was 35.8%, and the IFI-attributable mortality rate was 25%. In the multivariate analysis, relapsed disease was the most significant risk factor associated with mortality (P=0.006, odds ratio:4.745; 95% CI: 1.573-14.316). Conclusion: Mold-active prophylaxis reduced the rate of IFIs in this cohort however IFI-related mortality was still high as 25% in pediatric AML patients. Relapsed AML was the most significant risk factor associated with mortality. © 2023 Lippincott Williams and Wilkins. All rights reserved.en_US
dc.identifier.doi10.1097/MPH.0000000000002723
dc.identifier.endpage397en_US
dc.identifier.issn1077-4114
dc.identifier.issue7en_US
dc.identifier.pmid37526370en_US
dc.identifier.scopus2-s2.0-85173685990en_US
dc.identifier.scopusqualityQ3en_US
dc.identifier.startpage392en_US
dc.identifier.urihttps://doi.org/10.1097/MPH.0000000000002723
dc.identifier.urihttps://hdl.handle.net/11454/101123
dc.identifier.volume45en_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherLippincott Williams and Wilkinsen_US
dc.relation.ispartofJournal of Pediatric Hematology/Oncologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.snmz20240825_Gen_US
dc.subjectacute myeloid leukemiaen_US
dc.subjectchilden_US
dc.subjectfebrile neutropeniaen_US
dc.subjectinvasive fungal infectionen_US
dc.subjectalemtuzumaben_US
dc.subjectamikacinen_US
dc.subjectamphotericin Ben_US
dc.subjectcaspofunginen_US
dc.subjectcyclosporineen_US
dc.subjectgalactomannanen_US
dc.subjecthost factoren_US
dc.subjectmeropenemen_US
dc.subjectpiperacillin plus tazobactamen_US
dc.subjectprednisoneen_US
dc.subjectvoriconazoleen_US
dc.subjectAcremoniumen_US
dc.subjectacute myeloid leukemiaen_US
dc.subjectadolescenten_US
dc.subjectageen_US
dc.subjectantifungal susceptibilityen_US
dc.subjectArticleen_US
dc.subjectaspergillosisen_US
dc.subjectCandidaen_US
dc.subjectCandida albicansen_US
dc.subjectCandida glabrataen_US
dc.subjectCandida parapsilosisen_US
dc.subjectchilden_US
dc.subjectcomputer assisted tomographyen_US
dc.subjectenzyme immunoassayen_US
dc.subjectfebrile neutropeniaen_US
dc.subjectfemaleen_US
dc.subjectfungemiaen_US
dc.subjecthumanen_US
dc.subjectincidenceen_US
dc.subjectKluyveromyces marxianusen_US
dc.subjectleukemia relapseen_US
dc.subjectMagnusiomyces capitatusen_US
dc.subjectmajor clinical studyen_US
dc.subjectmaleen_US
dc.subjectmortality rateen_US
dc.subjectneutropeniaen_US
dc.subjectneutrophil counten_US
dc.subjectoutcome assessmenten_US
dc.subjectpneumoniaen_US
dc.subjectprophylaxisen_US
dc.subjectretrospective studyen_US
dc.subjectrisk factoren_US
dc.subjectschool childen_US
dc.subjectsepsisen_US
dc.subjectsystemic mycosisen_US
dc.subjectTrichosporon asahiien_US
dc.titleInvasive Fungal Infections in Children With Acute Myeloid Leukemia: A Single-center Experience Over 19 Yearsen_US
dc.typeArticleen_US

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