Mucormycosis in children with haematological malignancies is a salvageable disease: a report from the Israeli Study Group of Childhood Leukemia
| Autor: | Isaac Yaniv, Bella Bielorai, Joseph Kapelushnik, Mira Kharit, Gil Gilad, Sarah Elitzur, Ronit Nirel, Salvador Fischer, Nira Arad-Cohen, Amos Toren, Ronit Elhasid, Naomi Litichever, Shai Izraeli, Ruth Laor, Yael Shachor-Meyouhas, Itzhak Levy, Shlomit Barzilai-Birenboim, Yulia Shvartser-Beryozkin, Assaf A. Barg, Dror Raviv, Yariv Fruchtman, Osnat Konen |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Adolescent Childhood leukemia Disease Malignancy 03 medical and health sciences 0302 clinical medicine medicine Humans Mucormycosis Prospective Studies Israel Child business.industry Incidence (epidemiology) Hematology medicine.disease Leukemia Myeloid Acute Leukemia Hematologic Neoplasms 030220 oncology & carcinogenesis Cohort Female business Haematological malignancy 030215 immunology |
| Zdroj: | British Journal of Haematology. 189:339-350 |
| ISSN: | 1365-2141 0007-1048 |
| DOI: | 10.1111/bjh.16329 |
| Popis: | Mucormycosis has emerged as an increasingly important cause of morbidity and mortality in immunocompromised patients, but contemporary data in children are lacking. We conducted a nationwide multicentre study to investigate the characteristics of mucormycosis in children with haematological malignancies. The cohort included 39 children with mucormycosis: 25 of 1136 children (incidence 2·2%) with acute leukaemias prospectively enrolled in a centralized clinical registry in 2004-2017, and an additional 14 children with haematological malignancies identified by retrospective search of the databases of seven paediatric haematology centres. Ninety-two percent of mucormycosis cases occurred in patients with acute leukaemias. Mucormycosis was significantly associated with high-risk acute lymphoblastic leukaemia (OR 3·75; 95% CI 1·51-9·37; P = 0·004) and with increasing age (OR 3·58; 95% CI 1·24-9·77; P = 0·01). Fifteen patients (38%) died of mucormycosis. Rhinocerebral pattern was independently associated with improved 12-week survival (OR 9·43; 95% CI 1·47-60·66; P = 0·02) and relapsed underlying malignancy was associated with increased 12-week mortality (OR 6·42; 95% CI, 1·01-40·94; P = 0·05). In patients receiving frontline therapy for their malignancy (n = 24), one-year cumulative mucormycosis-related mortality was 21 ± 8% and five-year overall survival was 70 ± 8%. This largest paediatric population-based study of mucormycosis demonstrates that children receiving frontline therapy for their haematological malignancy are often salvageable. |
| Databáze: | OpenAIRE |
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