Abstract:
: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.
journal_name
Br J Haematoljournal_title
British journal of haematologyauthors
Elitzur S,Arad-Cohen N,Barg A,Litichever N,Bielorai B,Elhasid R,Fischer S,Fruchtman Y,Gilad G,Kapelushnik J,Kharit M,Konen O,Laor R,Levy I,Raviv D,Shachor-Meyouhas Y,Shvartser-Beryozkin Y,Toren A,Yaniv I,Nirel R,Idoi
10.1111/bjh.16329subject
Has Abstractpub_date
2020-04-01 00:00:00pages
339-350issue
2eissn
0007-1048issn
1365-2141journal_volume
189pub_type
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