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Invasive aspergillosis in children and adolescents with solid tumors: clinical cases and registry analysis
- Authors: Dinikina Y.V.1,2,3,4, Shadrivova O.V.5,6, Belogurova M.B.1,2,3,4, Melekhina Y.E.5,6, Ignatyeva S.M.5,6, Bogomolova T.S.5,6, Boychenko E.G.7,8, Kuleva S.A.9,10, Kolbin A.S.7,8, Klimko N.N.5,6
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Affiliations:
- V.A. Almazov National Medical Research Centre, Ministry of Health of Russia
- 2 Akkuratova St., Saint-Petersburg 197341
- Saint-Petersburg State Pediatric Medical University, Ministry of Health of Russia
- 2 Litovskaya St., Saint-Petersburg 194100
- I.I. Mechnikov North-Western State Medical University, Ministry of Health of Russia
- 1/28 Sant’yago-de-Kuba St., Saint-Petersburg 194291
- Municipal Children Hospital № 1
- 14 Avangardnaya St., Saint-Petersburg 198205
- N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of Russia
- 40 Vyborgskoe Shosse, Saint-Petersburg 194356
- Issue: Vol 14, No 1 (2019)
- Pages: 40-48
- Section: INFECTION PROBLEMS IN ONCOHEMATOLOGY
- Published: 10.04.2019
- URL: https://oncohematology.abvpress.ru/ongm/article/view/334
- DOI: https://doi.org/10.17650/1818-8346-2019-14-1-40-48
- ID: 334
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Abstract
We presented two cases of invasive aspergillosis (IA) in children with solid tumors, data of IA patients register, and a literature review. In the register of patients with IA (1997–2018), we found 57 patients with IA from 0 to 18 years. It was established that the number of patients with solid tumors was 15.7 %. Background diseases were: central nervous system tumors – 33.5 %, neuroblastoma – 33.5 %, osteosarcoma – 11.0 %, Wilms tumor – 11.0 %, hemangioblastoma – 11.0 %. Chemotherapy-induced neutropenia was reported in 100 % of IA cases in children and adolescents with solid tumors. The additional risk factors were treatment in intensive care unit – 22.2 %, high-dose chemotherapy with autologous hematopoietic stem cell transplantation – 22.2 %, concomitant bacterial infection – 33.0 %. Surgical intervention for the underlying disease was performed in 77.7 % of patients. The most common clinical site of IA was the lungs – 88.9 %. The predominant clinical sign was fever – 66.7 %, cough and respiratory failure were seen less frequently – 33.4 % and 33.4 %, respectively. The etiological agents of IA were Aspergillus fumigatus – 33.3 %, Aspergillus nidulans – 33.3 % and Aspergillus ustus – 33.3 %. 88.9 % of patients received antimycotic therapy, voriconazole predominantly – 66.7 %. Combination therapy was used in 33.3 % of patients. The overall 12-week survival in children and adolescents with IA in case of solid tumors was 77.8 %.
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About the authors
Yu. V. Dinikina
V.A. Almazov National Medical Research Centre, Ministry of Health of Russia; 2 Akkuratova St., Saint-Petersburg 197341; Saint-Petersburg State Pediatric Medical University, Ministry of Health of Russia; 2 Litovskaya St., Saint-Petersburg 194100
Author for correspondence.
Email: dinikina_yuv@almazovcentre.ru
ORCID iD: 0000-0002-2003-0982
Russian Federation
O. V. Shadrivova
I.I. Mechnikov North-Western State Medical University, Ministry of Health of Russia; 1/28 Sant’yago-de-Kuba St., Saint-Petersburg 194291Russian Federation
M. B. Belogurova
V.A. Almazov National Medical Research Centre, Ministry of Health of Russia; 2 Akkuratova St., Saint-Petersburg 197341; Saint-Petersburg State Pediatric Medical University, Ministry of Health of Russia; 2 Litovskaya St., Saint-Petersburg 194100
ORCID iD: 0000-0002-7471-7181
Russian Federation
Yu. E. Melekhina
I.I. Mechnikov North-Western State Medical University, Ministry of Health of Russia; 1/28 Sant’yago-de-Kuba St., Saint-Petersburg 194291Russian Federation
S. M. Ignatyeva
I.I. Mechnikov North-Western State Medical University, Ministry of Health of Russia; 1/28 Sant’yago-de-Kuba St., Saint-Petersburg 194291Russian Federation
T. S. Bogomolova
I.I. Mechnikov North-Western State Medical University, Ministry of Health of Russia; 1/28 Sant’yago-de-Kuba St., Saint-Petersburg 194291Russian Federation
E. G. Boychenko
Municipal Children Hospital № 1; 14 Avangardnaya St., Saint-Petersburg 198205Russian Federation
S. A. Kuleva
N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of Russia; 40 Vyborgskoe Shosse, Saint-Petersburg 194356Russian Federation
A. S. Kolbin
Municipal Children Hospital № 1; 14 Avangardnaya St., Saint-Petersburg 198205
ORCID iD: 0000-0002-1919-2909
Russian Federation
N. N. Klimko
I.I. Mechnikov North-Western State Medical University, Ministry of Health of Russia; 1/28 Sant’yago-de-Kuba St., Saint-Petersburg 194291
ORCID iD: 0000-0001-6095-7531
Russian Federation
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