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Review
. 2019 Feb 11;5(1):14.
doi: 10.3390/jof5010014.

Invasive Aspergillosis in Pediatric Leukemia Patients: Prevention and Treatment

Savvas Papachristou  1 , Elias Iosifidis  2 , Emmanuel Roilides  3
Affiliations
Review

Invasive Aspergillosis in Pediatric Leukemia Patients: Prevention and Treatment

Savvas Papachristou et al. J Fungi (Basel). .

Abstract

The purpose of this article is to review and update the strategies for prevention and treatment of invasive aspergillosis (IA) in pediatric patients with leukemia and in patients with hematopoietic stem cell transplantation. The major risk factors associated with IA will be described since their recognition constitutes the first step of prevention. The latter is further analyzed into chemoprophylaxis and non-pharmacologic approaches. Triazoles are the mainstay of anti-fungal prophylaxis while the other measures revolve around reducing exposure to mold spores. Three levels of treatment have been identified: (a) empiric, (b) pre-emptive, and (c) targeted treatment. Empiric is initiated in febrile neutropenic patients and uses mainly caspofungin and liposomal amphotericin B (LAMB). Pre-emptive is a diagnostic driven approach attempting to reduce unnecessary use of anti-fungals. Treatment targeted at proven or probable IA is age-dependent, with voriconazole and LAMB being the cornerstones in >2yrs and <2yrs age groups, respectively.

Keywords: Aspergillus; anti-fungal agents; hematological malignancies.

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Conflict of interest statement

Elias Roilides has received research grants from Astellas, Gilead, and Pfizer Inc. and is a scientific advisor and member of speaker bureaux for Astellas, Gilead, Merck, and Pfizer Inc. The other authors declare no conflict of interest.

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