Invasive Fungal Disease in Pediatric Acute Leukemia in the Nontransplant Setting: 8 Years' Experience From a Tertiary Care Center in North India. Issue 6 (August 2018)

• Record Type: Journal Article
• Authors: Das, Anirban; Oberoi, Sapna; Trehan, Amita; Chakrabarti, Arunaloke; Bansal, Deepak; Saxena, Akshay K.; Sodhi, Kushaljit S.; Kakkar, Nandita; Srinivasan, Radhika
• Is Part Of: Journal of pediatric hematology/oncology. Volume 40:Issue 6(2018)
• Publication Date: 2018-08
• Subjects: aspergillus -- CT -- galactomannan -- hospital stay -- mortality; Pediatric hematology -- Periodicals; Tumors in children -- Periodicals; 618.9215
• DOI: 10.1097/MPH.0000000000001027
• Languages: English
• ISSNs: 1077-4114

Abstract

Abstract : Background/Aim: The aim of this article is to study the spectrum, changing prevalence, and predictors for mortality of invasive fungal disease (IFD) in pediatric leukemia in a resource-limited setting. Observations: Prevalence was 7% (proven, 69%; probable, 16.4%; possible, 14.6%) and did not differ between acute lymphoblastic leukemia and acute myeloid leukemia. Lungs were frequently involved (46%). Aspergillus was the commonest fungus (47%). Visceral abscesses were frequent with candidiasis as compared with invasive molds ( P =0.016). IFD resulted in a prolonged admission (mean, 12.6±2 d; P =0.014) and death (44%) (Aspergillus, 50%; Candida, 50%; Mucor, 34%). Diagnosis of acute myeloid leukemia predicted mortality ( P =0.03). Conclusions: IFD was an important cause of treatment related mortality in pediatric leukemia (odds ratio, 8.39). Protocolled use of computed tomography-chest and galactomannan-assay aided diagnosis ( P <0.05).