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Perez P, Patiño J, Franco AA, Rosso F, Beltran E, Manzi E, Castro A, Estacio M, Valencia DM. Prophylaxis for invasive fungal infection in pediatric patients with allogeneic hematopoietic stem cell transplantation. Blood Res 2022; 57:34-40. [PMID: 35256547 PMCID: PMC8958374 DOI: 10.5045/br.2021.2021127] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 01/21/2022] [Accepted: 02/09/2022] [Indexed: 11/17/2022] Open
Abstract
Background Antifungal prophylaxis is recommended for hematopoietic stem cell transplantation (HSCT) to decrease the incidence of invasive fungal infections (IFI). This study aimed to compare the two groups of antifungal prophylaxis in pediatric patients undergoing allogeneic HSCT. Methods This observational, analytic, retrospective cohort study compared the incidence of IFI with antifungal prophylaxis with voriconazole vs. other antifungals in the first 100 days after allogeneic HSCT in patients aged <18 years between 2012 and 2018. The statistical analysis included univariate and multivariate analyses and determination of the cumulative incidence of invasive fungal infection by the Kaplan‒Meier method using STATA 14 statistical software. Results A total of 139 allogeneic HSCT were performed. The principal diagnosis was acute leukemia (63%). The 75% had haploidentical donors, and 50% used an antifungal in the month before transplantation. Voriconazole (69%) was the most frequently administered antifungal prophylaxis. The cumulative incidence of IFI was 5% (7 cases). Of the patients with IFIs, four began prophylaxis with voriconazole, one with caspofungin, and one with fluconazole. Additionally, six were possible cases, one was proven (Candida parapsilosis), and 1/7 died. Conclusion There were no differences in the incidence of IFI between patients who received prophylaxis with voriconazole and other antifungal agents.
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Affiliation(s)
- Paola Perez
- Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia
- Servicio de Infectología Pediátrica, Departamento Materno-infantil, Cali, Colombia
| | - Jaime Patiño
- Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia
- Servicio de Infectología Pediátrica, Departamento Materno-infantil, Cali, Colombia
| | - Alexis A. Franco
- Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia
- Unidad de trasplante de médula ósea, Departamento Materno-infantil, Cali, Colombia
| | - Fernando Rosso
- Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia
- Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cali, Colombia
| | - Estefania Beltran
- Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cali, Colombia
| | - Eliana Manzi
- Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia
- Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cali, Colombia
| | - Andrés Castro
- Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cali, Colombia
| | - Mayra Estacio
- Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cali, Colombia
| | - Diego Medina Valencia
- Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia
- Unidad de trasplante de médula ósea, Departamento Materno-infantil, Cali, Colombia
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