Incidence of invasive aspergillosis varies among children with leukemia
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Key takeaways:
- Infection occurred in 3.2% of children with acute lymphoblastic leukemia and 5.2% with acute myeloid leukemia.
- The case fatality rate for invasive aspergillosis ranged from 7.8% to 13.3%.
Invasive aspergillosis occurs in around 3% to 5% of children with acute leukemia, according to findings published in Journal of the Pediatric Infectious Diseases Society.
As Healio previously reported, Aspergillus infections can cause serious — or even fatal — illness for people with weakened immune systems.
“While we expected variability in the incidence and case fatality rates of invasive aspergillosis among children with acute leukemia, the extent of this variability between studies was particularly notable,” Rasmus Moeller Duus, MD, pediatrician and PhD student in the department of molecular medicine at University of Southern Denmark, told Healio. “This study highlights the need for uniform surveillance and early intervention in managing invasive aspergillosis in pediatric leukemia patients.”
The researchers conducted a systematic review and meta-analysis that included 24 studies conducted between Jan. 1, 2000, and July 31, 2023 — 14 of which reported data about patients with acute lymphoblastic leukemia (ALL) and 15 included data about acute myeloid leukemia (AML).
The ALL studies included 3,661 children with 86 cases of invasive aspergillosis, and the AML studies included 1,728 children with 69 cases of the fungal infection.
The incidence rate for invasive aspergillosis varied from 0% to 17% in ALL studies and 0% to 18% in AML studies. The researchers calculated pooled incidence rates of 2.8% (95% CI, 1.5%-5.1%) among patients with ALL and 4.9% (95% CI, 3%-7.9%) for patients with AML for all studies. The incidence rates for invasive aspergillosis were slightly higher among low risk of bias (RoB) studies (3.2%; 95% CI, 1.8%-5.8%; and 5.2%; 95% CI, 3.1%-8.6%, respectively).
Among 12 ALL studies, the pooled case fatality rate was 12.4% (95% CI; 6.5%-22.4%). The case fatality rate in nine low RoB studies was 13.3% (95% CI; 6.3%-25.9%).
The fatality rate was slightly lower among children with AML according to 12 total studies (11%; 95% CI, 1.9%-43.6%) and 11 low RoB studies (7.8%; 95% CI, 0.7%-51.2%).
“The pooled incidence rates were as high as anticipated, but we were pleasantly surprised to find that the case fatality rate was lower than expected compared to historical studies,” Duus said. “Despite this improvement, the case fatality rate in affected children remains high.”
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