Perez Paola, Patiño Jaime, Franco Alexis A, Rosso Fernando, Beltran Estefania, Manzi Eliana, Castro Andrés, Estacio Mayra, Valencia Diego Medina
Universidad Icesi, Facultad de Ciencias de la Salud, Colombia.
Fundación Valle del Lili, Departamento Materno-infantil, Servicio de Infectología Pediátrica, Colombia.
Blood Res. 2022 Mar 31;57(1):34-40. doi: 10.5045/br.2021.2021127.
Antifungal prophylaxis is recommended for hematopoietic stem cell transplantation (HSCT) to decrease the incidence of invasive fungal infections (IFI). This study aimed to compare the two groups of antifungal prophylaxis in pediatric patients undergoing allogeneic HSCT.
This observational, analytic, retrospective cohort study compared the incidence of IFI with antifungal prophylaxis with voriconazole vs. other antifungals in the first 100 days after allogeneic HSCT in patients aged <18 years between 2012 and 2018. The statistical analysis included univariate and multivariate analyses and determination of the cumulative incidence of invasive fungal infection by the Kaplan‒Meier method using STATA 14 statistical software.
A total of 139 allogeneic HSCT were performed. The principal diagnosis was acute leukemia (63%). The 75% had haploidentical donors, and 50% used an antifungal in the month before transplantation. Voriconazole (69%) was the most frequently administered antifungal prophylaxis. The cumulative incidence of IFI was 5% (7 cases). Of the patients with IFIs, four began prophylaxis with voriconazole, one with caspofungin, and one with fluconazole. Additionally, six were possible cases, one was proven (), and 1/7 died.
There were no differences in the incidence of IFI between patients who received prophylaxis with voriconazole and other antifungal agents.
造血干细胞移植（HSCT）推荐进行抗真菌预防以降低侵袭性真菌感染（IFI）的发生率。本研究旨在比较接受异基因HSCT的儿科患者中两组抗真菌预防措施的效果。
这项观察性、分析性、回顾性队列研究比较了2012年至2018年间年龄小于18岁的患者在异基因HSCT后前100天使用伏立康唑与其他抗真菌药物进行抗真菌预防时IFI的发生率。统计分析包括单因素和多因素分析，并使用STATA 14统计软件通过Kaplan-Meier方法确定侵袭性真菌感染的累积发生率。
共进行了139例异基因HSCT。主要诊断为急性白血病（63%）。75%的患者有单倍体相合供者，50%的患者在移植前一个月使用了抗真菌药物。伏立康唑（69%）是最常用的抗真菌预防药物。IFI的累积发生率为5%（7例）。在IFI患者中，4例开始使用伏立康唑预防，1例使用卡泊芬净，1例使用氟康唑。此外，6例为可能病例，1例为确诊病例，1/7死亡。
接受伏立康唑预防和其他抗真菌药物预防的患者之间IFI发生率无差异。
