Results of candidemia treatment in children with hematologic malignancies: single center experience

Candidemia is one of the most serious infectious complications in children with hematological malignancies and has a high morta lity rate.
Seven-year experience of candidemia diagnosis and therapy in patients with various hematologic malignancies w as analyzed. Candidemia registered in 37 patients (AML and MDS — 14, ALL — 10, solid tumors — 5, histocytic syndromes — 4, AA — 3, other non-malignancy diseases— 2). C. non-albicans (36 isolates from 32 patients) was common cause of, while C. albicans isolated in 5 patients (8 strains). Antifungal prophylactic therapy was applied to 31 patients. 22 patients at the time of candidemia have neutropenia (< 0.5 × 10 9/l). Main clinical manifestations were febrile fever (100 % cases) and pneumonia (21.6 % cases). Less frequent multiorgan failure (8.1 %), septic shoc k (5.4 %), chronic disseminated candidiasis (5.4 %) and meningitis (2.7 %) were registered. All patients received antifungal therapy (monotherapy — 17, combination therapy — 20). Central venous catheter removed in 21 patients. In 14 patients hematopoietic recovery w as registered, none of these patients died, while from group of patients without hematopoietic recovery 6 patients died (p = 0.0001). Recurrent candidemia episodes were seen in 4 patients. Overall survival was 0.37 ± 0.09.

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