PDF(Pubmed)
Abstract：
Acute leukemia accounts for more than 30% of all pediatric cancer cases, and of these, 15-20% are acute myeloid leukemia (AML). Children who super from AML are more likely to develop infections due to the humoral and cellular immune deficits generated by the disease and its treatment. The incidence of fungal infections is underestimated; reports show that up to 75% of fungal infections go undiagnosed until autopsy. In only 30 years, the incidence of invasive candidiasis has increased by 40-fold. Thus, the high morbidity and mortality associated with fungal infections in hematological patients make it necessary to adopt preventive measures.
This work aimed to retrospectively identify pediatric patients with acute myeloid leukemia and invasive fungal diseases (IFDs) in a Latin American tertiary care hospital. A retrospective analysis of 36 clinical records of pediatric patients diagnosed with AML from 2007 to 2017 was carried out.
One hundred and twenty-nine hospitalizations were associated with infectious events. Thirteen patients in our study presented 15 infectious events associated with IFDs (11.6%). Two patients died because of complications related to IFDs (15.3%). The most frequent IFD type was aspergillosis, which was observed in 7 cases, followed by Candidemia, which was observed in 4 cases. The most frequent clinical manifestations were fever and respiratory distress.
Mortality due to IFD can be prevented with effective pharmacotherapy. An appropriate antifungal prophylaxis strategy still needs to be developed through larger prospective studies in Latin America.
This work aimed to retrospectively identify pediatric patients with acute myeloid leukemia and invasive fungal diseases (IFDs) in a Latin American tertiary care hospital. A retrospective analysis of 36 clinical records of pediatric patients diagnosed with AML from 2007 to 2017 was carried out.
One hundred and twenty-nine hospitalizations were associated with infectious events. Thirteen patients in our study presented 15 infectious events associated with IFDs (11.6%). Two patients died because of complications related to IFDs (15.3%). The most frequent IFD type was aspergillosis, which was observed in 7 cases, followed by Candidemia, which was observed in 4 cases. The most frequent clinical manifestations were fever and respiratory distress.
Mortality due to IFD can be prevented with effective pharmacotherapy. An appropriate antifungal prophylaxis strategy still needs to be developed through larger prospective studies in Latin America.
摘要：
■急性白血病占所有儿科癌症病例的30％以上，其中，15-20％是急性髓细胞性白血病（AML）。由于疾病及其治疗产生的体液和细胞免疫缺陷，患有AML的儿童更有可能发生感染。真菌感染的发生率被低估；报告显示，高达75％的真菌感染直到尸检才被诊断出来。仅仅30年,侵袭性念珠菌病的发病率增加了40倍.因此，血液病患者与真菌感染相关的高发病率和高死亡率，因此有必要采取预防措施。
■这项工作旨在回顾性识别拉丁美洲三级保健医院中患有急性髓细胞性白血病和侵袭性真菌病（IFDs）的儿科患者。对2007年至2017年诊断为AML的36例儿科患者的临床记录进行回顾性分析。
■有一百二十九例住院与感染事件相关。在我们的研究中，有13例患者出现了15例与IFDs相关的感染事件（11.6％）。两名患者因与IFDs相关的并发症死亡(15.3%)。最常见的IFD类型是曲霉病，在7例中观察到，其次是念珠菌,在4例中观察到。最常见的临床表现是发热和呼吸窘迫。
■通过有效的药物治疗可以预防IFD引起的死亡率。在拉丁美洲，仍然需要通过更大的前瞻性研究来制定适当的抗真菌预防策略。
■这项工作旨在回顾性识别拉丁美洲三级保健医院中患有急性髓细胞性白血病和侵袭性真菌病（IFDs）的儿科患者。对2007年至2017年诊断为AML的36例儿科患者的临床记录进行回顾性分析。
■有一百二十九例住院与感染事件相关。在我们的研究中，有13例患者出现了15例与IFDs相关的感染事件（11.6％）。两名患者因与IFDs相关的并发症死亡(15.3%)。最常见的IFD类型是曲霉病，在7例中观察到，其次是念珠菌,在4例中观察到。最常见的临床表现是发热和呼吸窘迫。
■通过有效的药物治疗可以预防IFD引起的死亡率。在拉丁美洲，仍然需要通过更大的前瞻性研究来制定适当的抗真菌预防策略。
