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Risk Factors for Invasive Fungal Disease in Pediatric Cancer and Hematopoietic Stem Cell Transplantation: A Systematic Review.
- Source :
-
Journal of the Pediatric Infectious Diseases Society [J Pediatric Infect Dis Soc] 2018 Aug 17; Vol. 7 (3), pp. 191-198. - Publication Year :
- 2018
-
Abstract
- Background: Although a number of risk factors have been associated with invasive fungal disease (IFD), a systematic review of the literature to document pediatric-specific factors has not been performed.<br />Methods: We used the Ovid SP platform to search Medline, Medline In-Process, and Embase for studies that identified risk factors for IFD in children with cancer or those who undergo hematopoietic stem cell transplantation (HSCT). We included studies if they consisted of children or adolescents (<25 years) who were receiving treatment for cancer or undergoing HSCT and if the study evaluated risk factors among patients with and those without IFD.<br />Results: Among the 3566 studies screened, 22 studies were included. A number of pediatric factors commonly associated with an increased risk for IFD were confirmed, including prolonged neutropenia, high-dose steroid exposure, intensive-timing chemotherapy for acute myeloid leukemia, and acute and chronic graft-versus-host disease. Increasing age, a factor not commonly associated with IFD risk, was identified as a risk factor in multiple published cohorts.<br />Conclusions: With this systematic review, we have confirmed IFD risk factors that are considered routinely in daily clinical practice. Increasing age should also be considered when assessing patient risk for IFD. Future efforts should focus on defining more precise thresholds for a particular risk factor (ie, age, neutropenia duration) and on development of prediction rules inclusive of individual factors to further refine the risk prediction.
- Subjects :
- Adolescent
Adrenal Cortex Hormones adverse effects
Age Factors
Antineoplastic Agents adverse effects
Child
Graft vs Host Disease complications
Humans
Immunosuppressive Agents adverse effects
Invasive Fungal Infections drug therapy
Leukemia, Myeloid, Acute complications
Leukemia, Myeloid, Acute drug therapy
Neoplasms drug therapy
Neoplasms immunology
Neutropenia chemically induced
Neutropenia complications
Risk Factors
Hematopoietic Stem Cell Transplantation adverse effects
Invasive Fungal Infections diagnosis
Neoplasms therapy
Subjects
Details
- Language :
- English
- ISSN :
- 2048-7207
- Volume :
- 7
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Journal of the Pediatric Infectious Diseases Society
- Publication Type :
- Academic Journal
- Accession number :
- 28549148
- Full Text :
- https://doi.org/10.1093/jpids/pix030