Comment on: Invasive fungal infections in children with acute lymphoblastic leukemia

An evidence‐based, risk‐adapted algorithm for antifungal prophylaxis reduces risk for invasive mold infections in children with hematologic malignancies

“…Of the cases that had an IMI diagnosed during upfront therapy, the majority were given intensive treatment for high‐risk disease: 10 had AML, 19 had high‐risk B‐ALL, nine had T‐ALL, four had Ph+ ALL, two had infant ALL, and only three had standard‐risk ALL. This is consistent with observations made in prior publications 19,20 …”

“…This is consistent with observations made in prior publications. 19,20 We also demonstrate clinical benefit to implementation of a standardized approach to antifungal prophylaxis in high-risk childhood cancer populations, evidenced by risk reduction for proven/probable IMI after algorithm implementation. Although we cannot exclude the possibility of other factors contributing to this reduction, such as changes in therapeutic protocols and improved supportive care practices over time, our results support and extend findings from a prior, smaller single-institution study that also reported a reduction in IMI incidence after applying risk-adapted IMI prophylaxis in children with leukemia.…”

Fungal diagnostic testing and therapy: navigating the neutropenic period in children with high-risk leukemia

“…Contemporary stud ies sug gest that proven or prob a ble IFD rates in stan dard-risk ALL patients have declined to 5.8% but remain high at 12.9% for relapsed ALL patients and at 8.7% to 15.2% for high-risk ALL patients. 6,7 Although rates of IFD have var ied by time period and by leuke mia type, their per sis tence as oppor tu nis tic infec tions in these patient pop u la tions remains a con cern. IFDs con tinue to be a feared com pli ca tion of leu ke mia treat ment because of the potential for sig nif cant mor bid ity and mor tal ity asso ci ated with these path o gens.…”