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首页> 外文期刊>Journal of pediatric hematology/oncology: Official journal of the American Society of Pediatric Hematology/Oncology >Prolonged survival after invasive aspergillosis: a single-institution review of 11 cases.
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Prolonged survival after invasive aspergillosis: a single-institution review of 11 cases.

机译：侵袭性曲霉病后的生存期延长：单机构复查11例。

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PURPOSE: To perform a retrospective review of the authors' experience with invasive aspergillosis (IA) in a pediatric population treated with conventional chemotherapy. Case series of IA in the pediatric oncology population are limited but generally report poor overall survival. METHODS: Medical records were reviewed of all patients receiving conventional chemotherapy for malignant disease who developed IA at Children's Hospital and Regional Medical Center, Seattle, Washington, between January 1, 1995, and January 1, 2002. RESULTS: During the study period there were 11 cases of IA in pediatric cancer patients treated with conventional chemotherapy. All patients had pulmonary IA; two also had evidence of disseminated disease. All patients underwent diagnostic tissue biopsy. Sixty-four percent required further surgery to excise bulky disease. Medical therapy varied with disease presentation and the overall clinical picture, although prolonged treatment with amphotericin B and itraconazole was the mainstay of therapy. Resolution of clinical disease was seen in 91% of patients. Seventy-three percent received further chemotherapy. The 3-year estimated survival was 82%, with a median follow-up of 32.5 months. CONCLUSIONS: Early diagnosis and aggressive intervention improve long-term survival from IA in immunocompromised pediatric oncology patients. Aggressive surgical resection, prolonged medical therapy after gross resolution of disease, and chemoprophylaxis during subsequent chemotherapy decrease the likelihood of recurrent IA despite subsequent cytotoxic therapy. The ability to proceed with intensive chemotherapy despite a history of IA may improve long-term survival.
机译：目的：回顾性分析作者在接受常规化学疗法治疗的儿童人群中的侵袭性曲霉病（IA）的经历。儿科肿瘤学人群的IA病例系列很有限，但总体报告总体生存率较差。方法：回顾了1995年1月1日至2002年1月1日在华盛顿州西雅图市儿童医院和地区医疗中心接受过恶性疾病常规化疗的所有患者的病历。结果：在研究期间常规化疗治疗小儿癌症患者11例IA。所有患者均患有肺部IA。两个人也有传播疾病的证据。所有患者均接受了诊断性组织活检。 64％的人需要进一步手术切除大块的疾病。尽管长期使用两性霉素B和伊曲康唑治疗是治疗的主要手段，但药物治疗随疾病的表现和总体临床情况而异。 91％的患者看到了临床疾病的消退。 73％的患者接受了进一步的化疗。 3年估计生存率为82％，中位随访32.5个月。结论：早期诊断和积极干预可改善免疫受损小儿肿瘤患者的IA长期生存率。尽管进行了细胞毒性治疗，但积极的外科手术切除，疾病大体消退后的长期药物治疗以及后续化疗期间的化学预防措施降低了复发性IA的可能性。尽管有IA病史，但仍可继续进行强化化疗，这可能会改善长期生存率。

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