Original scientific paper

https://doi.org/10.20471/acc.2022.61.04.11

Invasive Fungal Infections in Children Treated for Hematologic Malignancies – A Five-Year Single Center Experience

Domagoj Buljan ; Department of Oncology and Hematology, Zagreb Children’s Hospital, Zagreb, Croatia
Izabela Kranjčec ; Department of Oncology and Hematology, Zagreb Children’s Hospital, Zagreb, Croatia
Ivan Pavić ; Department of Pediatrics, Division of Pulmonology, Zagreb Children’s Hospital, Zagreb, Croatia; School of Medicine, University of Split, Split, Croatia
Paola Krnjaić ; Department of Pediatrics, Dubrovnik General Hospital, Dubrovnik, Croatia
Sanela Šalig ; Varaždin County Health Center, Varaždin, Croatia
Gordana Jakovljević ; Department of Oncology and Hematology, Zagreb Children’s Hospital, Zagreb, Croatia; School of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
Jasminka Stepan Giljević ; Department of Oncology and Hematology, Zagreb Children’s Hospital, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia

Abstract

Invasive fungal infections (IFI) are life-threatening complications of intensive chemotherapy
treatment, with the incidence in pediatric patients ranging from 2% to 21%. In this article,
we describe our 5-year experience of IFI in pediatric oncology patients and its clinical manifestations
with radiological findings, treatment and outcome. A retrospective and descriptive survey of IFI in
children with hematologic neoplasms was conducted at the Department of Oncology and Hematology,
Zagreb Children’s Hospital. Medical charts of children 0-17 years of age, of both sexes, treated for
leukemias and lymphomas from January 2016 to December 2020 were reviewed. In a 5-year period,
60 patients were treated for hematologic malignancy, acute lymphoblastic leukemia (ALL) being the
most prevalent diagnosis. IFI was verified in 9 (15%) children, predominantly in patients with ALL
(75%). The specific causative agent was detected in one child, whereas other infections were classified
as probable pulmonary aspergillosis. All the patients received standard prophylaxis with fluconazole
and treatment with liposomal amphotericin B and voriconazole. The majority of our patients achieved
recovery. IFI prevention, diagnosis and treatment remain a challenge. Uniform prophylaxis and therapy
protocols, as well as environmental control are of vital importance for the development of better
strategies in the prevention, early detection and treatment of IFI in pediatric hematology patients.

Keywords

Antifungal agents; Hematologic neoplasms; Invasive fungal infection

Hrčak ID:

301957

URI

https://hrcak.srce.hr/301957

Publication date:

1.12.2022.

Article data in other languages: croatian

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