Invasive fungal diseases in children with hematologic disorders

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dc.contributor.buuauthorBaytan, Birol
dc.contributor.buuauthorGüneş, Adalet Meral
dc.contributor.buuauthorÇelebi, Solmaz
dc.contributor.buuauthorGünay, Ünsal
dc.contributor.departmentUludağ Üniversitesi/Tıp Fakültesi/Pediatrik Hematoloji Anabilim Dalı.tr_TR
dc.contributor.departmentUludağ Üniversitesi/Tıp Fakültesi/Çocuk Enfeksiyon Hastalıkları Anabilim Dalı.tr_TR
dc.contributor.scopusid6506622162tr_TR
dc.contributor.scopusid24072843300tr_TR
dc.contributor.scopusid7006095295tr_TR
dc.contributor.scopusid6603885274tr_TR
dc.date.accessioned2022-02-25T07:33:40Z
dc.date.available2022-02-25T07:33:40Z
dc.date.issued2009-12
dc.description.abstractObjective: Fungal infection is a significant problem, causing of infective deaths of leukemic patients. The situation in developing countries is not well documented. The purpose of this study was characterizing IFD by analyzing data retrospectively to determine the incidence, predisposing factors, diagnostic methods, efficacy of treatment, and the outcome in pediatric patients with hematological disorders. Materials and Methods: There were 160 children with leukemia (22 AML, 129 ALL) and 9 with aplastic anemia (AA). The diagnostic criteria for IFD were defined according to the EORTC/MSG, 2008, IFD was classified as proven or probable. Empiric antifungal treatment with L-AmB was commenced by day 5-7 of persistent fever. Patients with invasive aspergillosis (IA) who were refractory to primary treatment were commenced on voriconazole (VCZ). Salvage therapy as combination of VCZ and caspofungin was given to those with progressive infection. Results: The incidence of IFD was found 23 (14.3%). 19 with leukemia (14 ALL, 5 AML) and 4 with aplastic anemia were diagnosed as IFD. IA was the dominant cause of infection (n=17) and the rest (n: 6) had candidiasis. Ten children had "proven" infection and 13 children were defined as "probable". The most frequent site of infection was lungs. In our series, the most frequently used diagnostic methods were clinical findings (100%) and radiologic methods (84%). The success rate of treatment for candidiasis and IA were found 60%, 71% respectively. IFD related death rate was found 30%. Conclusion: IFD is still a major morbidity and mortality reason in children with hematologic disorders. However, the availability of new antifungal treatments and diagnostic tests will improve the survival rates in these children. (Turk J Hematol 2009; 26: 190-6)en_US
dc.description.abstractFungal infeksiyonlar lösemili hastalarda infeksiyonlardan ölümlerde önemli bir sorundur. Bu sorun gelişmekte olan ülkelerde iyi dökümente edilmemiştir. Bu çalışmanın amacı, geriye dönük olarak çocuk hastalarda görülen hematolojik hastalıklardaki invazif fungal hastalık (İFH) insidansını, predispozan faktörleri, tanı metodları, tedavi etkiliği ve sonuçlarını incelemektir. : Merkezimizde Ocak 2003 ve Aralık 2008 tarihleri arasında tedavi edilen 160 lösemili (22 AML, 129 ALL) ve 9 aplastik anemili olgu çalışmaya alındı. EORTC-MSG 2008 kriterlerine göre olgulara olası veya kesin İFH tanısı kondu. Antibiyotik tedavisine rağmen 5 günden uzun süren ateş yüksekliği saptanan olgulara ampirik antifungal tedavi olarak L-AmB başlandı. İnvasive aspergillozis (IA) saptanan olgularda tedavi voriconazole (VCZ) değiştirildi. Kurtarma tedavisinde VCZ ve kaspofungin kombinasyonu kullanıldı. Bulgular: Çalışmamızda İFH %14,3 (n: 23) bulundu. 19 lösemili(14 ALL, 5 AML) ve 4 aplastik anemili olguda IFH tanısı kondu. IA en sık rastlanan enfeksiyon oldu (n: 17), diğer 6 olguda kandidiazis saptandı. On olguya kesin ve 13 olguya kuvvetli olası enfeksiyon tanısı kondu. En sık tutulan enfeksiyon bölgesi akciğerdi. Çalışmamızda, en sık kullanılan tanı yöntemleri; klinik bulgular (%100) ve radyolojik metodlar (%84) olarak saptandı. Tedavide başarı oranları kandidiasis ve IA’da %60 ve %71 bulundu. İFH ile ilişkili ölüm oranı %30 saptandı. Sonuç: Sonuç olarak, İFH hala hematolojik hastalıklı olgularda ciddi mortalite morbitide sebebidir. Ancak yeni antifungal ilaçlar ve tanı yöntemleri ile yaşam oranları artmaktadırtr_TR
dc.identifier.citationBaytan, B. vd. (2009). "Invasive fungal diseases in children with hematologic disorders". Turkish Journal of Hematology, 26(4), 190-196.tr_TR
dc.identifier.endpage196tr_TR
dc.identifier.issn1300-7777
dc.identifier.issue4tr_TR
dc.identifier.pubmed27265631tr_TR
dc.identifier.scopus2-s2.0-73649128266tr_TR
dc.identifier.startpage190tr_TR
dc.identifier.urihttp://hdl.handle.net/11452/24648
dc.identifier.volume26tr_TR
dc.identifier.wos000272964200006tr_TR
dc.indexed.pubmedPubmeden_US
dc.indexed.scopusScopusen_US
dc.indexed.trdizinTrDizintr_TR
dc.indexed.wosSCIEen_US
dc.language.isoenen_US
dc.publisherGalenos Yayıncılıktr_TR
dc.relation.journalTurkish Journal of Hematologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergitr_TR
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectChildrenen_US
dc.subjectHematologic disordersen_US
dc.subjectInvasive fungal infectionen_US
dc.subjectImmunocompromised pediatric-patientsen_US
dc.subjectBlood-stream infectionsen_US
dc.subjectMycoses study-groupen_US
dc.subjectAntifungal therapyen_US
dc.subjectAcute-leukemiaen_US
dc.subjectEuropean-organizationen_US
dc.subjectCombination therapyen_US
dc.subjectAspergillosisen_US
dc.subjectDiagnosisen_US
dc.subjectGalactomannanen_US
dc.subjectHematologyen_US
dc.subjectHematolojik hastalıklartr_TR
dc.subjectÇocuktr_TR
dc.subjectİnvazif mantar infeksiyonutr_TR
dc.subject.emtreeAmphotericin B lipid complexen_US
dc.subject.emtreeCaspofunginen_US
dc.subject.emtreeVoriconazoleen_US
dc.subject.emtreeAcute granulocytic leukemiaen_US
dc.subject.emtreeAcute lymphoblastic leukemiaen_US
dc.subject.emtreeAdolescenten_US
dc.subject.emtreeAplastic anemiaen_US
dc.subject.emtreeArticleen_US
dc.subject.emtreeAspergillosisen_US
dc.subject.emtreeCandida albicansen_US
dc.subject.emtreeCandidiasisen_US
dc.subject.emtreeChilden_US
dc.subject.emtreeClinical featureen_US
dc.subject.emtreeCoughingen_US
dc.subject.emtreeDiagnostic testen_US
dc.subject.emtreeDisease predispositionen_US
dc.subject.emtreeDrug efficacyen_US
dc.subject.emtreeDyspneaen_US
dc.subject.emtreeFemaleen_US
dc.subject.emtreeFeveren_US
dc.subject.emtreeHeadacheen_US
dc.subject.emtreeHematologic diseaseen_US
dc.subject.emtreeHemoptysisen_US
dc.subject.emtreeHumanen_US
dc.subject.emtreeIncidenceen_US
dc.subject.emtreeLungen_US
dc.subject.emtreeMajor clinical studyen_US
dc.subject.emtreeMaleen_US
dc.subject.emtreeMortalityen_US
dc.subject.emtreeMycosisen_US
dc.subject.emtreeNeurologic diseaseen_US
dc.subject.emtreeOutcome assessmenten_US
dc.subject.emtreePleural painen_US
dc.subject.emtreeRisk factoren_US
dc.subject.emtreeSalvage therapyen_US
dc.subject.emtreeSchool childen_US
dc.subject.emtreeTachypneaen_US
dc.subject.scopusInvasive Aspergillosis; Galactomannans; Systemic Mycosisen_US
dc.subject.wosHematologyen_US
dc.titleInvasive fungal diseases in children with hematologic disordersen_US
dc.typeArticle

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