An investigation into invasive aspergillosis prophylaxis in children with acute lymphoblastic leukemia receiving polychemotherapy protocols

摘要

Introduction:Currently,invasiveaspergillosis(IA)prophylaxisisroutinelyincludedinacutemyeloidleukemiatreatmentprotocols.Atthesametimeacutelymphoidleukemia(ALL)chemotherapymayalsobeassociatedwiththeincreasedriskofIA.TheaimofourstudywastoassumethevalidityofIAprophylaxisinthesupportivetreatmentofALLpatientsduringinductionofremissionandconsolidationtreatment.Materialandmethods:Twenty-onepatientswithnewlydiagnosedALLwereincludedintheinvestigation.Patientsreceivedchemotherapyaccordingtointernationalprotocols.ThediagnosisofIAwasbasedonthepresenceofaspergillusantigengalactomannanintheblood,bronchoalveolarlavage,liquor,andcomputertomographydata.Results:IAduringtheinductionandconsolidationtreatmentphaseofALLwasdiagnosedin14patients(67%).Duringconsolidationtreatment6cases(43%),andduringinductiontreatment5cases(36%)ofIAwerediagnosed.In3patients(14%)IAwasdiagnosedbeforetheonsetofchemotherapyoronmaintenancetherapy.Thefrequencyofproveninvasiveaspergillosiswas0%,frequencyofprobableinvasiveaspergillosiswas21%andfrequencyofpossibleinvasiveaspergillosiswas79%.Attributivelethalitywas0%.Conclusion:InvasiveaspergillosisisanimportantcomplicationinALLchemotherapytreatmentthatcanaffectthetherapyschedule.AIprophylaxisduringinductionandconsolidationtreatmentcanpossiblyreducetheriskofitsoccurrence.Thelowfrequencyofprovenandprobableaspergillosisandthelowlethalityinthisgroupofpatientscallsforfurtherinvestigation.