Voriconazole for invasive aspergillosis in oncohematological patients: a single-center pediatric experience

Area of Science:

• Mycology
• Pediatric Oncology
• Infectious Diseases

Background:

• Invasive aspergillosis poses a significant threat to immunocompromised pediatric patients, especially those with hematologic malignancies.
• Limited data exist on the efficacy and safety of voriconazole in pediatric populations for treating invasive aspergillosis.

Purpose of the Study:

• To evaluate the effectiveness and tolerability of voriconazole as a salvage therapy for invasive aspergillosis in pediatric patients.
• To assess voriconazole's role in treating children with hematologic malignancies and invasive fungal infections.

Main Methods:

• Retrospective case series of seven pediatric patients with invasive aspergillosis treated with voriconazole.
• Patients had underlying conditions including acute lymphoblastic leukemia, acute myeloid leukemia, refractory anemia with excess of blasts, and severe aplastic anemia.
• Voriconazole was administered for a median of 8 weeks as a salvage treatment after initial therapy.

Main Results:

• Voriconazole treatment resulted in complete response in two patients, partial response in one, and stable disease in one.
• Two patients experienced treatment failure, and four patients died, two from progressive aspergillosis.
• Voriconazole was generally well-tolerated, and survival was observed in three patients at 4-6 months post-diagnosis.

Conclusions:

• Voriconazole appears to be an effective salvage treatment for invasive aspergillosis in pediatric patients, especially those recovering from neutropenia or not experiencing relapses.
• Further research is warranted to confirm voriconazole's role in pediatric invasive aspergillosis management.
• The tolerability profile suggests voriconazole can be a valuable option in difficult-to-treat pediatric fungal infections.