TY - JOUR

T1 - Invasive aspergillosis in children and adolescents with solid tumors

T2 - Clinical cases and registry analysis

AU - Dinikina, Yu V.

AU - Shadrivova, O. V.

AU - Belogurova, M. B.

AU - Melekhina, Yu E.

AU - Ignatyeva, S. M.

AU - Bogomolova, T. S.

AU - Boychenko, E. G.

AU - Kuleva, S. A.

AU - Kolbin, A. S.

AU - Klimko, N. N.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - We presented two cases of invasive aspergillosis (IA) in children with solid tumors, data of IA patients register, and a literature review. In the register of patients with IA (1997-2018), we found 57 patients with IA from 0 to 18 years. It was established that the number of patients with solid tumors was 15.7 %. Background diseases were: central nervous system tumors - 33.5 %, neuroblastoma - 33.5 %, osteosarcoma - 11.0 %, Wilms tumor - 11.0 %, hemangioblastoma - 11.0 %. Chemotherapy-induced neutropenia was reported in 100 % of IA cases in children and adolescents with solid tumors. The additional risk factors were treatment in intensive care unit - 22.2 %, high-dose chemotherapy with autologous hematopoietic stem cell transplantation - 22.2 %, concomitant bacterial infection - 33.0 %. Surgical intervention for the underlying disease was performed in 77.7 % of patients. The most common clinical site of IA was the lungs - 88.9 %. The predominant clinical sign was fever - 66.7 %, cough and respiratory failure were seen less frequently - 33.4 % and 33.4 %, respectively. The etiological agents of IA were Aspergillus fumigatus - 33.3 %, Aspergillus nidulans - 33.3 % and Aspergillus ustus - 33.3 %. 88.9 % of patients received antimycotic therapy, voriconazole predominantly - 66.7 %. Combination therapy was used in 33.3 % of patients. The overall 12.week survival in children and adolescents with IA in case of solid tumors was 77.8 %.

AB - We presented two cases of invasive aspergillosis (IA) in children with solid tumors, data of IA patients register, and a literature review. In the register of patients with IA (1997-2018), we found 57 patients with IA from 0 to 18 years. It was established that the number of patients with solid tumors was 15.7 %. Background diseases were: central nervous system tumors - 33.5 %, neuroblastoma - 33.5 %, osteosarcoma - 11.0 %, Wilms tumor - 11.0 %, hemangioblastoma - 11.0 %. Chemotherapy-induced neutropenia was reported in 100 % of IA cases in children and adolescents with solid tumors. The additional risk factors were treatment in intensive care unit - 22.2 %, high-dose chemotherapy with autologous hematopoietic stem cell transplantation - 22.2 %, concomitant bacterial infection - 33.0 %. Surgical intervention for the underlying disease was performed in 77.7 % of patients. The most common clinical site of IA was the lungs - 88.9 %. The predominant clinical sign was fever - 66.7 %, cough and respiratory failure were seen less frequently - 33.4 % and 33.4 %, respectively. The etiological agents of IA were Aspergillus fumigatus - 33.3 %, Aspergillus nidulans - 33.3 % and Aspergillus ustus - 33.3 %. 88.9 % of patients received antimycotic therapy, voriconazole predominantly - 66.7 %. Combination therapy was used in 33.3 % of patients. The overall 12.week survival in children and adolescents with IA in case of solid tumors was 77.8 %.

KW - Aspergillosis

KW - Chemotherapy

KW - Children

KW - Invasive mycosis

KW - Oncology

KW - Solid tumors

UR - http://www.scopus.com/inward/record.url?scp=85069553279&partnerID=8YFLogxK

U2 - 10.17650/1818-8346-2019-14-1-40-48

DO - 10.17650/1818-8346-2019-14-1-40-48

M3 - Article

AN - SCOPUS:85069553279

VL - 14

SP - 40

EP - 48

JO - Онкогематология

JF - Онкогематология

SN - 1818-8346

IS - 1

ER -