Invasive fungal infections in pediatric patients with hematologic malignancies receiving oral amphotericin b solution and early intravenous administration of fluconazole

Nobuhiro Watanabe, Kimikazu Matsumoto, Seiji Kojima, Koji Kato

    Research output: Contribution to journalArticle

    8 Citations (Scopus)

    Abstract

    This study aimed to determine the frequency of invasive fungal infection (IFI) in pediatric patients with hematologic malignancy who received amphotericin B oral suspension and early intravenous fluconazole during the neutropenic phase as prophylaxis for IFI. Records of 743 neutropenic episodes induced by cytotoxic chemotherapy between 1997 and 2008 were retrospectively reviewed to determine risk factors for and frequency of IFI. The overall frequency of IFI was 0.8% (n=6) and frequencies of proven, probable, and possible infections were 0.3% (n=2), 0.4% (n=3), and 0.1% (n=1), respectively. During 351 episodes of profound neutropenia (neutrophil count <500/μL for ≥14 d), overall incidence of IFI was 1.71% (n=6). Pulmonary aspergillosis was the most common causative agent, and no patients showed candidemia, or hepatosplenic candidiasis. Cytotoxic chemotherapy regimens for acute myelogenous leukemia and profound neutropenia were significantly associated with IFI (P=0.004 and P=0.009, respectively). No IFI-attributable deaths or breakthrough fungal infections occurred. Our results indicate that amphotericin B oral solution and early intravenous fluconazole may be effective in reducing the incidence and mortality of IFI in pediatric patients with hematologic malignancies.

    Original languageEnglish
    Pages (from-to)270-275
    Number of pages6
    JournalJournal of Pediatric Hematology/Oncology
    Volume33
    Issue number4
    DOIs
    Publication statusPublished - May 1 2011

    Fingerprint

    Fluconazole
    Amphotericin B
    Hematologic Neoplasms
    Intravenous Administration
    Pediatrics
    Neutropenia
    Pulmonary Aspergillosis
    Candidemia
    Drug Therapy
    Invasive Fungal Infections
    Mycoses
    Candidiasis
    Incidence
    Proxy
    Acute Myeloid Leukemia
    Suspensions
    Neutrophils
    Mortality
    Infection

    All Science Journal Classification (ASJC) codes

    • Pediatrics, Perinatology, and Child Health
    • Hematology
    • Oncology

    Cite this

    Invasive fungal infections in pediatric patients with hematologic malignancies receiving oral amphotericin b solution and early intravenous administration of fluconazole. / Watanabe, Nobuhiro; Matsumoto, Kimikazu; Kojima, Seiji; Kato, Koji.

    In: Journal of Pediatric Hematology/Oncology, Vol. 33, No. 4, 01.05.2011, p. 270-275.

    Research output: Contribution to journalArticle

    @article{01cd9a2cafc6475cbea0d4033f66334f,
    title = "Invasive fungal infections in pediatric patients with hematologic malignancies receiving oral amphotericin b solution and early intravenous administration of fluconazole",
    abstract = "This study aimed to determine the frequency of invasive fungal infection (IFI) in pediatric patients with hematologic malignancy who received amphotericin B oral suspension and early intravenous fluconazole during the neutropenic phase as prophylaxis for IFI. Records of 743 neutropenic episodes induced by cytotoxic chemotherapy between 1997 and 2008 were retrospectively reviewed to determine risk factors for and frequency of IFI. The overall frequency of IFI was 0.8{\%} (n=6) and frequencies of proven, probable, and possible infections were 0.3{\%} (n=2), 0.4{\%} (n=3), and 0.1{\%} (n=1), respectively. During 351 episodes of profound neutropenia (neutrophil count <500/μL for ≥14 d), overall incidence of IFI was 1.71{\%} (n=6). Pulmonary aspergillosis was the most common causative agent, and no patients showed candidemia, or hepatosplenic candidiasis. Cytotoxic chemotherapy regimens for acute myelogenous leukemia and profound neutropenia were significantly associated with IFI (P=0.004 and P=0.009, respectively). No IFI-attributable deaths or breakthrough fungal infections occurred. Our results indicate that amphotericin B oral solution and early intravenous fluconazole may be effective in reducing the incidence and mortality of IFI in pediatric patients with hematologic malignancies.",
    author = "Nobuhiro Watanabe and Kimikazu Matsumoto and Seiji Kojima and Koji Kato",
    year = "2011",
    month = "5",
    day = "1",
    doi = "10.1097/MPH.0b013e31820acfc7",
    language = "English",
    volume = "33",
    pages = "270--275",
    journal = "Journal of Pediatric Hematology/Oncology",
    issn = "1077-4114",
    publisher = "Lippincott Williams and Wilkins",
    number = "4",

    }

    TY - JOUR

    T1 - Invasive fungal infections in pediatric patients with hematologic malignancies receiving oral amphotericin b solution and early intravenous administration of fluconazole

    AU - Watanabe, Nobuhiro

    AU - Matsumoto, Kimikazu

    AU - Kojima, Seiji

    AU - Kato, Koji

    PY - 2011/5/1

    Y1 - 2011/5/1

    N2 - This study aimed to determine the frequency of invasive fungal infection (IFI) in pediatric patients with hematologic malignancy who received amphotericin B oral suspension and early intravenous fluconazole during the neutropenic phase as prophylaxis for IFI. Records of 743 neutropenic episodes induced by cytotoxic chemotherapy between 1997 and 2008 were retrospectively reviewed to determine risk factors for and frequency of IFI. The overall frequency of IFI was 0.8% (n=6) and frequencies of proven, probable, and possible infections were 0.3% (n=2), 0.4% (n=3), and 0.1% (n=1), respectively. During 351 episodes of profound neutropenia (neutrophil count <500/μL for ≥14 d), overall incidence of IFI was 1.71% (n=6). Pulmonary aspergillosis was the most common causative agent, and no patients showed candidemia, or hepatosplenic candidiasis. Cytotoxic chemotherapy regimens for acute myelogenous leukemia and profound neutropenia were significantly associated with IFI (P=0.004 and P=0.009, respectively). No IFI-attributable deaths or breakthrough fungal infections occurred. Our results indicate that amphotericin B oral solution and early intravenous fluconazole may be effective in reducing the incidence and mortality of IFI in pediatric patients with hematologic malignancies.

    AB - This study aimed to determine the frequency of invasive fungal infection (IFI) in pediatric patients with hematologic malignancy who received amphotericin B oral suspension and early intravenous fluconazole during the neutropenic phase as prophylaxis for IFI. Records of 743 neutropenic episodes induced by cytotoxic chemotherapy between 1997 and 2008 were retrospectively reviewed to determine risk factors for and frequency of IFI. The overall frequency of IFI was 0.8% (n=6) and frequencies of proven, probable, and possible infections were 0.3% (n=2), 0.4% (n=3), and 0.1% (n=1), respectively. During 351 episodes of profound neutropenia (neutrophil count <500/μL for ≥14 d), overall incidence of IFI was 1.71% (n=6). Pulmonary aspergillosis was the most common causative agent, and no patients showed candidemia, or hepatosplenic candidiasis. Cytotoxic chemotherapy regimens for acute myelogenous leukemia and profound neutropenia were significantly associated with IFI (P=0.004 and P=0.009, respectively). No IFI-attributable deaths or breakthrough fungal infections occurred. Our results indicate that amphotericin B oral solution and early intravenous fluconazole may be effective in reducing the incidence and mortality of IFI in pediatric patients with hematologic malignancies.

    UR - http://www.scopus.com/inward/record.url?scp=79955521525&partnerID=8YFLogxK

    UR - http://www.scopus.com/inward/citedby.url?scp=79955521525&partnerID=8YFLogxK

    U2 - 10.1097/MPH.0b013e31820acfc7

    DO - 10.1097/MPH.0b013e31820acfc7

    M3 - Article

    C2 - 21464763

    AN - SCOPUS:79955521525

    VL - 33

    SP - 270

    EP - 275

    JO - Journal of Pediatric Hematology/Oncology

    JF - Journal of Pediatric Hematology/Oncology

    SN - 1077-4114

    IS - 4

    ER -