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J. Fungi 2019, 5(1), 14; https://doi.org/10.3390/jof5010014

Invasive Aspergillosis in Pediatric Leukemia Patients: Prevention and Treatment

Infectious Diseases Unit, 3rd Department of Pediatrics, Faculty of Medicine, Aristotle University School of Health Sciences, Konstantinoupoleos 49, 54642 Thessaloniki, Greece
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Received: 4 December 2018 / Revised: 5 February 2019 / Accepted: 5 February 2019 / Published: 11 February 2019
(This article belongs to the Special Issue Fungal Infections in Immunocompromised Hosts)
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PDF [286 KB, uploaded 11 February 2019]

Abstract

The purpose of this article is to review and update the strategies for prevention and treatment of invasive aspergillosis (IA) in pediatric patients with leukemia and in patients with hematopoietic stem cell transplantation. The major risk factors associated with IA will be described since their recognition constitutes the first step of prevention. The latter is further analyzed into chemoprophylaxis and non-pharmacologic approaches. Triazoles are the mainstay of anti-fungal prophylaxis while the other measures revolve around reducing exposure to mold spores. Three levels of treatment have been identified: (a) empiric, (b) pre-emptive, and (c) targeted treatment. Empiric is initiated in febrile neutropenic patients and uses mainly caspofungin and liposomal amphotericin B (LAMB). Pre-emptive is a diagnostic driven approach attempting to reduce unnecessary use of anti-fungals. Treatment targeted at proven or probable IA is age-dependent, with voriconazole and LAMB being the cornerstones in >2yrs and <2yrs age groups, respectively. View Full-Text
Keywords: Aspergillus; anti-fungal agents; hematological malignancies Aspergillus; anti-fungal agents; hematological malignancies
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Papachristou, S.; Iosifidis, E.; Roilides, E. Invasive Aspergillosis in Pediatric Leukemia Patients: Prevention and Treatment. J. Fungi 2019, 5, 14.

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