Frequency and Treatment Outcome of Invasive Fungal Infections in Children with Hematological Malignancies

Abstract

Background: Invasive fungal infections are the cause of significant morbidity and mortality among cancer patients of any age group. This research aimed to determine the frequency and treatment outcome of invasive fungal infections in children with hematological malignancies. Methods: This cohort study was performed at the Department of Pediatric Oncology, Combined Military Hospital, Rawalpindi, Pakistan, from January 2022 to June 2023. Children of either gender aged less than 18 years diagnosed with hematological malignancies were included adopting a non-probability consecutive sampling technique. Treatment followed “Berlin-Frankfurt-Münster (BFM)” based protocols. Outcome in the form of mortality was noted by the end of the study period. Results: A total of 240 cases of various types of hematological malignancies during the study period and 41 (17.1%) cases were found to have invasive fungal infections. In 41 invasive fungal infections, 28 (68.3%) were male. The mean age was 6.35±3.72 years. Invasive fungal infection was found to be possible, probable, and proven in 34 (82.9%), 6 (14.6%), and 1 (2.4%) cases respectively. Amphotericin B was the most frequent anti-fungal, advised in 23 (56.1%) cases whereas voriconazole was given in 14 (41.5%) patients. The mean duration of treatment was 21±19 days (ranging between 2 to 84 days). Mortality was reported among 10 (24.4%) cases. Conclusion: The frequency of IFS was 17.1% among children with hematological malignancies. Mortality was relatively high (24.4%) among children with IFIs which warrants early identification and treatment of IFIs among children with hematological malignancies.

Keywords

• Amphotericin B
• Acute Lymphoblastic leukaemia
• Acute Myeloid leukaemia
• Invasive Fungal Infection
• Voriconazole