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Epidemiology of invasive fungal diseases in children with solid tumours undergoing autologous haematopoietic stem cell transplantation: a 10‐year experience in a tertiary Italian centre
Authors:Paola Tatarelli  Maura Faraci  Ilaria Caviglia  Roberto Bandettini  Giuliana Cangemi  Gian Michele Magnano  Alberto Garaventa  Claudio Viscoli  Elio Castagnola
Affiliation:1. Infectious Diseases Division, University of Genoa (DISSAL) and IRCCS San Martino‐IST, Genoa, Italy;2. Department of Hematology and Oncology, Istituto Giannina Gaslini, Children's Hospital, Genoa, Italy;3. Infectious Diseases Unit, Istituto Giannina Gaslini, Children's Hospital, Genoa, Italy;4. Laboratory of Microbiology, Istituto Giannina Gaslini, Children's Hospital, Genoa, Italy;5. Clinical Pathology Laboratory Unit, Istituto Giannina Gaslini, Children's Hospital, Genoa, Italy;6. Department of Radiology, Istituto Giannina Gaslini, Children's Hospital, Genoa, Italy
Abstract:The objective of the study was to determine the incidence of invasive fungal disease (IFD) in children undergoing autologous haematopoietic stem cell transplantation (auHSCT) for solid tumours (ST). Retrospective study on auHSCT was performed in children with ST (January 2006‐December 2015). Data on the number of patient‐days at risk (pdr) during the first 30 and 90 days after auHSCT and cases of proven/probable IFDs were collected. Infection rate (IR, episodes/1000 pdr) and proportions and cumulative risk (CR) of IFD were evaluated. In 186 patients, 270 auHSCT were performed, for a total of 8327 pdr during the first 30 days and 24 366 up to day 90. Median age was 5 years (interquartile range 2;8), 63% were male. At day 30, seven procedures were complicated by IFD, with an IR of 0.84 (95% CI 0.66‐1.02) and aCR of 2.6% (95% CI 1.4‐5.4) at 18 days after HSCT. Within day 90, two further IFDs were detected with an IR of 0.37 (95% CI ?0.49 to 1.23) and a CR of 3.3% (95% CI 1.7‐6.3) at day 69. Children undergoing auHSCT for ST have a low incidence of IFDs in the first 90 days after the procedure.
Keywords:autologous haematopoietic stem cell transplantation  candidaemia  children  invasive fungal diseases  pre‐engraftment period  solid tumours
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