Infectious Disease Research Program, Center for Bone Marrow Transplantation and Department of Pediatric Hematology/Oncology, University Children's Hospital, Münster, Germany.
Infectious Diseases Unit, Department of Pediatrics, Istituto "Giannina Gaslini", Genova, Italy.
Lancet Oncol. 2014 Jul;15(8):e327-40. doi: 10.1016/S1470-2045(14)70017-8.
Invasive opportunistic fungal diseases (IFDs) are important causes of morbidity and mortality in paediatric patients with cancer and those who have had an allogeneic haemopoietic stem-cell transplantation (HSCT). Apart from differences in underlying disorders and comorbidities relative to those of adults, IFDs in infants, children, and adolescents are unique with respect to their epidemiology, the usefulness of diagnostic methods, the pharmacology and dosing of antifungal agents, and the absence of interventional phase 3 clinical trials for guidance of evidence-based decisions. To better define the state of knowledge on IFDs in paediatric patients with cancer and allogeneic HSCT and to improve IFD diagnosis, prevention, and management, the Fourth European Conference on Infections in Leukaemia (ECIL-4) in 2011 convened a group that reviewed the scientific literature on IFDs and graded the available quality of evidence according to the Infectious Diseases Society of America grading system. The final considerations and recommendations of the group are summarised in this manuscript.
侵袭性机会性真菌病（IFD）是儿童癌症患者和异基因造血干细胞移植（HSCT）患者发病率和死亡率的重要原因。除了与成人相比在基础疾病和合并症方面存在差异外，婴儿、儿童和青少年的 IFD 在流行病学、诊断方法的实用性、抗真菌药物的药理学和剂量以及缺乏干预性 III 期临床试验方面具有独特性，无法为循证决策提供指导。为了更好地定义癌症和异基因 HSCT 患儿 IFD 的知识现状，改善 IFD 的诊断、预防和管理，2011 年第四届欧洲白血病感染会议（ECIL-4）召集了一个小组，该小组回顾了 IFD 的科学文献，并根据美国传染病学会的分级系统对现有证据质量进行了分级。该小组的最终考虑和建议总结在本手稿中。
