Table 1.
Clinical characteristics of 308 pediatric allogenic HCT recipients.
| Patient Characterisitcs | Total No. of Patients (%) | Invasive Fungal Infection | p-Value | ||||
|---|---|---|---|---|---|---|---|
| Yes | No | ||||||
| No. of Patients (%) | No. of Patients (%) | ||||||
| 308 | 18 (5.8) | 290 (94.2) | |||||
| Gender | |||||||
| Male | 184 | 8 | 176 | ||||
| Female | 124 | 10 | 114 | ||||
| sd | sd | sd | |||||
| Median patient Age [min-max] | 8.6 (0.1–20) | 5.3 | 11.9 (2–19) | 5.6 | 8.4 (0.1–20) | 5.2 | 0.0089 |
| <10 years old | 188 (61) | 6 (33.3) | 182 (62.4) | 0.014 | |||
| Indication for HCT | |||||||
| Malignant disease | 176 (57) | 13 (72.2) | 163 (56.2) | ||||
| ALL | 86 (27.9) | 5 (27.8) | 81 (27.9) | ||||
| AML | 50 (16.2) | 2 (11.1) | 48 (16.6) | ||||
| CR2 or more | 83 (26.9) | 7 (38.9) | 76 (26.2) | 0.022 | |||
| Non-Malignant disease | 127 (41.2) | 5 (27.8) | 122 (42.1) | ||||
| Primary immunodeficiencies | 43 (14.0) | 1 (5.5) | 42 (14.5) | ||||
| Thalassemia | 18 (5.8) | 0 (0) | 18 (6.2) | ||||
| Sickle cell disease | 16 (5.2) | 0 (0) | 16 (5.5) | ||||
| Metabolic disorders | 5 (1.6) | 0 (0) | 5 (1.7) | ||||
| Type of donor | |||||||
| Matched related donor | 106 (34.4) | 6 (33.3) | 100 (34.5) | ||||
| Unrelated donor | 188 (61.0) | 12 (66.6) | 176 (60.7) | ||||
| Haplo-identical donor | 14 (4.5) | 0 (0) | 14 (4.8) | ||||
| Stem cell source | |||||||
| Bone marrow | 229 (74.3) | 11 (61.1) | 218 (75.2) | ||||
| PBSC | 19 (6.2) | 2 (11.1) | 17 (5.9) | ||||
| Cord blood unit | 56 (18.2) | 5 (27.8) | 51 (17.6) | ||||
| Mixed | 4 (1.3) | 0 (0) | 4 (1.4) | ||||
| Type of conditionning | |||||||
| Myeloablative regimen | 293 (95.1) | 17 (94.4) | 276 (95.2) | ||||
| With Busulfan | 185 (60.1) | 8 (44.4) | 177 (61) | ||||
| With TBI | 79 (25.6) | 9 (50.0) | 70 (24.1) | 0.007 | |||
| RIC | 15 (4.9) | 1 (5.55) | 14 (6.7) | ||||
| Acute GVHD occurrence | 186 (60.4) | 9 (50.0) | 177 (61) | ||||
| severe (grade III–IV) | 48 (15.6) | 4 (22.2) | 44 (15.2) | ||||
| Chronic GVHD occurrence | 69 (22.4) | 4 (22.2) | 65 (22.4) | ||||
| severe (grade III–IV) | 28 (9.1) | 0 (0) | 28 (9.7) | ||||
| High dose steroid administration after HCT * | 170 (55.2) | sd | 11 (61,1) | sd | 159 (54.8) | sd | |
| Mean duration of steroid (days) [min–max] | 90.8 (7–365) | 70 | 46 (30–214) | 70.5 | 91.3 (7–365) | 70.3 | |
| Immunosuppressive treatment used in 2nd line Treatment after high steroid administration |
63 (20.5) | 4 (22.2) | 59 (20.3) | ||||
| Relapse post-aHCT | 36 (11.7) | 2 (11.1) | 34 (11.7) | ||||
| Engraftment failure ** | 16 (5.2) | 2 (11.1) | 14 (4.8) | ||||
| sd | sd | sd | |||||
| Mean neutrophil recovery [min-max] | 22.9 (10–79) | 9.3 | 19.3 (12–31) | 6.2 | 23.2 (10–79) | 9.4 | |
| Antifungal prophylaxis | 50 (16.2) | 2 (11.1) | 48 (16.6) | ||||
| Primary prophylaxis | 23 (7.5) | 1 (5.5) | 22 (7.6) | ||||
| Secondary prophylaxis | 27 (8.8) | 1 (5.5) | 26 (9) | ||||
Abreviations: HCT: hematopoietic stem cell transplantation; ALL: acute llymphoblastic leukemia; AML: acute myeloblastic leukemia; CR2: complete remission 2; PBSC: peripheric bone stem cell; TBI: total body irridiation; RIC: reduced intensity conditionning; GVH: graft versus host disease; CTC: corticotherapy; IFI: invasive fungal infection; * Receiving prednisolone with a minimal dosage of 1 mg/kg/day for more than a week; ** Engraftment failure was defined when there was less than 40% of donor cell engraftment (chimerism) 3, 6 and 12 months after aHCT.