Impact of Fungal Infection on the Continuity of Chemotherapy and Disease Outcome during Induction and Consolidation Therapy of Childhood Acute Lymphoblastic Leukemia

Abstract

The incidence of severe fungal infections in immunocompromised patients has increased dramatically over the past 20 years. In neutropenic patients, these infections are a major cause of morbidity and mortality. Between 20% to 40% of mycoses in patients with hematological malignancies are disseminated and more than 70% of these are fatal. Candidiasis and Aspergillosis are the most common fungal infections in patients receiving immunosuppressive therapy In order to study Impact of fungal infection on the continuity of chemotherapy and disease outcome during induction and consolidation therapy of childhood acute lymphoblastic leukemia, we retrieved the archived clinical & biological & laboratory data of 96 patient, consisting all patients diagnosed with ALL during the time period between January 2012 till December 2012 according to St. Jude’s total XV protocol for low risk, standard risk /high risk. Out of the 96 cases who diagnosed Acute ymphoblastic leukemia, the incidence of probable fungal infection detected is 19/96 (19.8%) cases. Out of 19 cases had probable fungal infection 12/19 (63.2%) cases were low risk, 6/19 (31.6%) cases were standard risk, 1/19 (5.3%) cases were High risk. Out of 19 cases who diagnosed acute lymphoblastic leukemia with probable fungal infection, 7/19(36.80%) cases had delay of chemotherapy. Out of 77 cases who diagnosed Acute lymphoblastic leukemia with no probable fungal infection detected, 4/77 (5.20%) cases had delay of chemotherapy. Out of 19 cases who diagnosed acute lymphoblastic leukemia with probable fungal infection, 3/19 (15.80%) cases died. Regarding state of their diseases, out of 19cases probable fungal infection, 18/19 (94.7%) were in (CR) complete remission, while 1/19 cases (5.3%) were not in remission (not in CR). Fungal infection is one of the major problems during induction and consolidation of acute lymphoblastic leukemia patients, affect the outcome & continuity of chemotherapy.