Invasive Fungal Disease in Pediatric Acute Leukemia in the Nontransplant Setting: 8 Years’ Experience From a Tertiary Care Center in North India

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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).

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