Abstract
The incidence of invasive fungal infections has increased in recent years among children with hematological malignancies. The extensive use of antifungal prophylaxis has resulted in limited success. Candida spp. other than C. albicans are being isolated more frequently, and incidences of aspergillosis, as well as infections due to previously uncommon organisms, are also on the rise. Empirical antifungal therapy has been standard treatment for persistent or relapsing antibiotic resistant fever, but early preemptive therapy based on serological tests and image diagnosis may offer more effective antifungal control. Amphotericin B remains the antifungal agent with the broadest spectrum of action available and thus constitutes the standard treatment for patients with proven or suspected fungal infections despite its potential for nephrotoxity. Several new antifungals have become available, including lipid formations of amphotericic B, which may allow it to be administered with reduced toxicity. However, there is still no consensus on the strategy of antifungal treatment in children with hematological malignancies, because of the paucity of pediatric data. This article provides a brief overreview of the current status of invasive fungal infections and systemic antifungal therapy in children with hematological malignancies.
