Prolonged survival after invasive aspergillosis: a single-institution review of 11 cases
- PMID: 12679641
- DOI: 10.1097/00043426-200304000-00004
Prolonged survival after invasive aspergillosis: a single-institution review of 11 cases
Abstract
Purpose: To perform a retrospective review of the authors' experience with invasive aspergillosis (IA) in a pediatric population treated with conventional chemotherapy. Case series of IA in the pediatric oncology population are limited but generally report poor overall survival.
Methods: Medical records were reviewed of all patients receiving conventional chemotherapy for malignant disease who developed IA at Children's Hospital and Regional Medical Center, Seattle, Washington, between January 1, 1995, and January 1, 2002.
Results: During the study period there were 11 cases of IA in pediatric cancer patients treated with conventional chemotherapy. All patients had pulmonary IA; two also had evidence of disseminated disease. All patients underwent diagnostic tissue biopsy. Sixty-four percent required further surgery to excise bulky disease. Medical therapy varied with disease presentation and the overall clinical picture, although prolonged treatment with amphotericin B and itraconazole was the mainstay of therapy. Resolution of clinical disease was seen in 91% of patients. Seventy-three percent received further chemotherapy. The 3-year estimated survival was 82%, with a median follow-up of 32.5 months.
Conclusions: Early diagnosis and aggressive intervention improve long-term survival from IA in immunocompromised pediatric oncology patients. Aggressive surgical resection, prolonged medical therapy after gross resolution of disease, and chemoprophylaxis during subsequent chemotherapy decrease the likelihood of recurrent IA despite subsequent cytotoxic therapy. The ability to proceed with intensive chemotherapy despite a history of IA may improve long-term survival.
Similar articles
-
Invasive pulmonary aspergillosis in neutropenic patients during hospital construction: before and after chemoprophylaxis and institution of HEPA filters.Am J Hematol. 2001 Apr;66(4):257-62. doi: 10.1002/ajh.1054. Am J Hematol. 2001. PMID: 11279636
-
Pulmonary resection for invasive Aspergillus infections in immunocompromised patients.J Thorac Cardiovasc Surg. 1995 Jun;109(6):1182-96; discussion 1196-7. doi: 10.1016/S0022-5223(95)70202-4. J Thorac Cardiovasc Surg. 1995. PMID: 7776682
-
Predicting outcome after lung resection for invasive pulmonary aspergillosis in patients with neutropenia.Chest. 2004 Dec;126(6):1783-8. doi: 10.1378/chest.126.6.1783. Chest. 2004. PMID: 15596674
-
[Pulmonary aspergillosis in the neutropenic patient. Apropos of 4 cases].Tunis Med. 1996 Nov;74(11):493-500. Tunis Med. 1996. PMID: 9506113 Review. French. No abstract available.
-
Therapeutic outcome and prognostic factors of invasive aspergillosis in an infectious disease department: a review of 34 cases.Infection. 2008 Dec;36(6):533-8. doi: 10.1007/s15010-008-7375-x. Epub 2008 Nov 13. Infection. 2008. PMID: 19011743 Review.
Cited by
-
Invasive pulmonary and central nervous system aspergillosis in a child: A case report and literature review.Medicine (Baltimore). 2024 Feb 9;103(6):e37160. doi: 10.1097/MD.0000000000037160. Medicine (Baltimore). 2024. PMID: 38335438 Free PMC article. Review.
-
A Systematic Review to Assess the Relationship between Disseminated Cerebral Aspergillosis, Leukemias and Lymphomas, and Their Respective Therapeutics.J Fungi (Basel). 2022 Jul 11;8(7):722. doi: 10.3390/jof8070722. J Fungi (Basel). 2022. PMID: 35887477 Free PMC article. Review.
-
Pediatric Invasive Aspergillosis.J Fungi (Basel). 2016 Jun 13;2(2):19. doi: 10.3390/jof2020019. J Fungi (Basel). 2016. PMID: 29376936 Free PMC article. Review.
-
The efficacy of voriconazole in the treatment of 192 fungal central nervous system infections: a retrospective analysis.Infection. 2011 Jun;39(3):201-10. doi: 10.1007/s15010-011-0108-6. Epub 2011 Apr 22. Infection. 2011. PMID: 21512792
-
Itraconazole prophylaxis in pediatric cancer patients receiving conventional chemotherapy or autologous stem cell transplants.Support Care Cancer. 2007 Feb;15(2):213-20. doi: 10.1007/s00520-006-0125-7. Epub 2006 Aug 30. Support Care Cancer. 2007. PMID: 16944217
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical