PMID- 29608706
OWN - NLM
STAT- MEDLINE
DCOM- 20190906
LR  - 20191210
IS  - 1460-2709 (Electronic)
IS  - 1369-3786 (Linking)
VI  - 57
IP  - 2
DP  - 2019 Feb 1
TI  - Risks and outcomes of invasive fungal infections in pediatric allogeneic 
      hematopoietic stem cell transplant recipients receiving fluconazole prophylaxis: 
      a multicenter cohort study by the Turkish Pediatric Bone Marrow Transplantation 
      Study Group.
PG  - 161-170
LID - 10.1093/mmy/myy015 [doi]
AB  - Invasive fungal infections (IFIs) are a major cause of infection-related 
      morbidity and mortality in patients undergoing allogeneic hematopoietic stem cell 
      transplantation (HSCT). Data from pediatric settings are scarce. To determine the 
      incidence, risk factors and outcomes of IFIs in a 180-day period 
      post-transplantation, 408 pediatric patients who underwent allogeneic HSCT were 
      retrospectively analyzed. The study included only proven and probable IFIs. The 
      cumulative incidences of IFI were 2.7%, 5.0%, and 6.5% at 30, 100, and 180 days 
      post-transplantation, respectively. According to the multivariate analysis, the 
      factors associated with increased IFI risk in the 180-day period post-HSCT were 
      previous HSCT history (hazard ratio [HR], 4.57; 95% confidence interval [CI] 
      1.42-14.71; P = .011), use of anti-thymocyte globulin (ATG) (HR, 2.94; 95% CI 
      1.27-6.80; P = .012), grade III-IV acute graft-versus-host-disease (GVHD) (HR, 
      2.91; 95% CI 1.24-6.80; P = .014) and late or no lymphocyte engraftment (HR, 
      2.71; 95% CI 1.30-5.62; P = .007). CMV reactivation was marginally associated 
      with an increased risk of IFI development (HR, 1.91; 95% CI 0.97-3.74; P = .063). 
      IFI-related mortality was 1.5%, and case fatality rate was 27.0%.The close 
      monitoring of IFIs in pediatric patients with severe acute GVHD who receive ATG 
      during conditioning is critical to reduce morbidity and mortality after 
      allogeneic HSCT, particularly among those with prior HSCT and no or late 
      lymphocyte engraftment.
FAU - Hazar, Volkan
AU  - Hazar V
AD  - Department of Pediatric Hematology&Oncology and BMT Unit, Medical Park Goztepe 
      Hospital, Istanbul.
FAU - Karasu, Gulsun Tezcan
AU  - Karasu GT
AD  - Department of Pediatric Hematology&Oncology and BMT Unit, Medical Park Goztepe 
      Hospital, Istanbul.
FAU - Uygun, Vedat
AU  - Uygun V
AD  - Department of Pediatric Hematology&Oncology and BMT Unit, Medical Park Antalya 
      Hospital, Antalya.
FAU - Ozturk, Gulyuz
AU  - Ozturk G
AD  - Department of Pediatric Hematology&Oncology and BMT Unit, Acibadem University 
      Faculty of Medicine, Acibadem Atakent Hospital, Istanbul.
FAU - Kilic, Suar Caki
AU  - Kilic SC
AD  - Department of Pediatric Hematology&Oncology and BMT Unit, Medical Park Goztepe 
      Hospital, Istanbul.
FAU - Kupesiz, Alphan
AU  - Kupesiz A
AD  - Department of Pediatric Hematology&Oncology and BMT Unit, Akdeniz University 
      Faculty of Medicine, Antalya.
FAU - Daloglu, Hayriye
AU  - Daloglu H
AD  - Department of Pediatric Hematology&Oncology and BMT Unit, Medical Park Antalya 
      Hospital, Antalya.
FAU - Aksoylar, Serap
AU  - Aksoylar S
AD  - Department of Pediatric Hematology&Oncology and BMT Unit, Ege University Faculty 
      of Medicine, Izmir.
FAU - Atay, Didem
AU  - Atay D
AD  - Department of Pediatric Hematology&Oncology and BMT Unit, Acibadem University 
      Faculty of Medicine, Acibadem Atakent Hospital, Istanbul.
FAU - Ince, Elif Unal
AU  - Ince EU
AD  - Department of Pediatric Hematology&Oncology and BMT Unit, Ankara University 
      Faculty of Medicine, Ankara.
FAU - Karakukcu, Musa
AU  - Karakukcu M
AD  - Department of Pediatric Hematology&Oncology and BMT Unit, Erciyes University 
      Faculty of Medicine, Kayseri.
FAU - Ozbek, Namik
AU  - Ozbek N
AD  - Department of Pediatric Hematology&Oncology and BMT Unit, Ankara Child Health and 
      Diseases Hematology Oncology Training and Research Hospital, Ankara.
FAU - Tayfun, Funda
AU  - Tayfun F
AD  - Department of Pediatric Hematology&Oncology and BMT Unit, Akdeniz University 
      Faculty of Medicine, Antalya.
FAU - Kansoy, Savas
AU  - Kansoy S
AD  - Department of Pediatric Hematology&Oncology and BMT Unit, Ege University Faculty 
      of Medicine, Izmir.
FAU - Ozyurek, Emel
AU  - Ozyurek E
AD  - Department of Pediatric Hematology&Oncology and BMT Unit, Medical Park Samsun 
      Hospital, Samsun.
FAU - Akcay, Arzu
AU  - Akcay A
AD  - Department of Pediatric Hematology&Oncology and BMT Unit, Acibadem University 
      Faculty of Medicine, Acibadem Atakent Hospital, Istanbul.
FAU - Gursel, Orhan
AU  - Gursel O
AD  - Department of Pediatric Hematology&Oncology and BMT Unit, Gulhane Military 
      Medical Academy, Ankara.
FAU - Haskologlu, Sule
AU  - Haskologlu S
AD  - Department of Pediatric Hematology&Oncology and BMT Unit, Ankara University 
      Faculty of Medicine, Ankara.
FAU - Kaya, Zuhre
AU  - Kaya Z
AD  - Department of Pediatric Hematology&Oncology and BMT Unit, Gazi University Faculty 
      of Medicine, Ankara.
FAU - Yilmaz, Sebnem
AU  - Yilmaz S
AD  - Department of Pediatric Hematology&Oncology and BMT Unit, Dokuz Eylul University 
      Faculty of Medicine, Izmir.
FAU - Tanyeli, Atila
AU  - Tanyeli A
AD  - Department of Pediatric Hematology&Oncology and BMT Unit, Cukurova University 
      Faculty of Medicine, Adana.
FAU - Yesilipek, Akif
AU  - Yesilipek A
AD  - Department of Pediatric Hematology&Oncology and BMT Unit, Medical Park Antalya 
      Hospital, Antalya.
AD  - The Chief of the Turkish Pediatric BMT Study Group.
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PT  - Multicenter Study
PL  - England
TA  - Med Mycol
JT  - Medical mycology
JID - 9815835
RN  - 8VZV102JFY (Fluconazole)
SB  - IM
MH  - Adolescent
MH  - *Antibiotic Prophylaxis/standards
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Fluconazole/*therapeutic use
MH  - Follow-Up Studies
MH  - *Hematopoietic Stem Cell Transplantation
MH  - Humans
MH  - Incidence
MH  - Infant
MH  - Invasive Fungal Infections/drug therapy/*epidemiology/mortality/*prevention & 
      control
MH  - Male
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Survival Analysis
MH  - Transplantation, Homologous
MH  - Turkey/epidemiology
EDAT- 2018/04/03 06:00
MHDA- 2019/09/07 06:00
CRDT- 2018/04/03 06:00
PHST- 2017/11/22 00:00 [received]
PHST- 2018/03/04 00:00 [accepted]
PHST- 2018/04/03 06:00 [pubmed]
PHST- 2019/09/07 06:00 [medline]
PHST- 2018/04/03 06:00 [entrez]
AID - 4955662 [pii]
AID - 10.1093/mmy/myy015 [doi]
PST - ppublish
SO  - Med Mycol. 2019 Feb 1;57(2):161-170. doi: 10.1093/mmy/myy015.