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Invasive fungal infections in paediatric acute myeloid leukaemia |
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| Authors: | D. L. Johnston V. Lewis R. Yanofsky B. Gillmeister M. C. Ethier D. Mitchell S. Cellot D. Dix C. Portwine V. Price M. Silva S. Zelcer B. Michon L. Bowes K. Stobart J. Brossard J. Beyene L. Sung |
| Affiliation: | 1. Hematology Oncology, Children's Hospital of Eastern Ontario, , Ottawa, ON, Canada;2. Hematology/Oncology/Transplant Program, Alberta Children's Hospital, , Calgary, AB, Canada;3. Hematology/Oncology, CancerCare Manitoba, , Winnipeg, MB, Canada;4. Child Health Evaluative Sciences, The Hospital for Sick Children, , Toronto, ON, Canada;5. Hematology/Oncology, Montreal Children's Hospital, , Montreal, QC, Canada;6. Hematology/Oncology, Hospital Sainte‐Justine, , Montreal, QC, Canada;7. Pediatric Hematology/Oncology, British Columbia Children's Hospital, , Vancouver, BC, Canada;8. Hematology/Oncology, McMaster Children's Hospital at Hamilton Health Sciences, , Hamilton, ON, Canada;9. Pediatrics, IWK Health Centre, , Halifax, NS, Canada;10. Hematology/Oncology, Cancer Centre of Southeastern Ontario at Kingston, , Kingston, ON, Canada;11. Hematology/Oncology, London Health Sciences, , London, ON, Canada;12. Pediatric Hematology/Oncology Centre, Hospitalier Universitaire de Quebec, , Quebec City, QC, Canada;13. Hematology/Oncology, Janeway Child Health Center, , St John's, NL, Canada;14. Stollery Children's Hospital, University of Alberta Hospital, , Edmonton, AB, Canada;15. Hematology/Oncology, Centre Hospitalier Universitaire de Sherbrooke, , Sherbrooke, QC, Canada;16. Population Genomics Program, Department of Clinical Epidemiology and Biostatistics, McMaster University, , Hamilton, ON, Canada;17. Division of Haematology/Oncology, The Hospital for Sick Children, , Toronto, ON, Canada |
| Abstract: | Invasive fungal infections (IFIs) are a major cause of morbidity and mortality in paediatric acute myeloid leukaemia (AML). This study describes risk factors for IFI and IFI‐related sepsis in this population. We conducted a population‐based, retrospective cohort study of children with AML in Canada. IFIs during chemotherapy and prior to haematopoietic stem cell transplantation, relapse, persistent disease or death were identified. Risk factors for proven or probable IFI were examined. Among courses complicated by IFI, risk factors for sepsis were also evaluated. There were 341 children with AML included of which 41 (12.0%) experienced 46 different episodes of IFI. Candida species accounted for 23 (50.0%) of IFIs and Aspergillus spp. accounted for 14 (30.4%). Days of broad‐spectrum antibiotics, days of corticosteroids and neutropenia at start of the course were independently associated with IFI. Only days of fever were independently associated with IFI‐related sepsis. Invasive fungal infections occurred in 12.0% of paediatric AML patients. Risk factors for IFI and IFI‐related sepsis were identified. This knowledge may help to consider targeted strategies. |
| Keywords: | Fungal infection paediatric acute myeloid leukaemia risk factors |