nodgoРоссийский журнал детской гематологии и онкологии (РЖДГиО)Russian Journal of Pediatric Hematology and Oncology2311-12672413-5496LTD “Graphica”10.17650/2311-1267-2015-1-88-91nodgo-84Research ArticleПРОБЛЕМЫ ПРАКТИЧЕСКОЙ ГЕМАТОЛОГИИ-ОНКОЛОГИИPROBLEMS OF PRACTICAL HEMATOLOGY/ONCOLOGYПодходы к профилактике грибковой инфекции у детей после трансплантации гемопоэтических стволовых клеток – опыт Российской детской клинической больницы (обзор литературы и собственный опыт)Approaches to the prevention of fungal infections in children after hematopoietic stem cell transplantation – the experience of the Russian Children's Clinical Hospital (Literature review and own experience)КонстантиноваВероника ВладиковнаKonstantinovaV. V.

Россия, 117997, Москва, Ленинский просп., 117

117 Leninskiy Prosp., Moscow, 117997, Russia

veronika_md@mail.ruКиргизовК. И.KirgizovK. I.

Россия, 117997, Москва, Ленинский просп., 117

117 Leninskiy Prosp., Moscow, 117997, Russia

ПристансковаЕ. А.PristanskovaE. A.

Россия, 117997, Москва, Ленинский просп., 117

117 Leninskiy Prosp., Moscow, 117997, Russia

СидороваН. В.SidorovaN. V.

Россия, 117997, Москва, Ленинский просп., 117

117 Leninskiy Prosp., Moscow, 117997, Russia

БуряА. Е.BuryaA. E.

Россия, 117997, Москва, Ленинский просп., 117

117 Leninskiy Prosp., Moscow, 117997, Russia

БлагонравоваО. Л.BuryaO. L.

Россия, 117997, Москва, Ленинский просп., 117

117 Leninskiy Prosp., Moscow, 117997, Russia

ГерасимоваЮ. В.GerasimovaY. V.

Россия, 117997, Москва, Ленинский просп., 117

117 Leninskiy Prosp., Moscow, 117997, Russia

ФедороваН. И.FedorovaN. I.

Россия, 117997, Москва, Ленинский просп., 117

117 Leninskiy Prosp., Moscow, 117997, Russia

СкоробогатоваЕ. В.SkorobogatovaE. V.

Россия, 117997, Москва, Ленинский просп., 117

117 Leninskiy Prosp., Moscow, 117997, Russia

ФГБУ «Российская детская клиническая больница» Минздрава РоссииРоссия"Russian Children's Clinical Hospital", Ministry of Health of RussiaRussian Federation201523052015218891Copyright © Константинова В.В., Киргизов К.И., Пристанскова Е.А., Сидорова Н.В., Буря А.Е., Благонравова О.Л., Герасимова Ю.В., Федорова Н.И., Скоробогатова Е.В., 20152015Константинова В.В., Киргизов К.И., Пристанскова Е.А., Сидорова Н.В., Буря А.Е., Благонравова О.Л., Герасимова Ю.В., Федорова Н.И., Скоробогатова Е.В.Konstantinova V.V., Kirgizov K.I., Pristanskova E.A., Sidorova N.V., Burya A.E., Burya O.L., Gerasimova Y.V., Fedorova N.I., Skorobogatova E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nodgo.org/jour/article/view/84

В статье представлены современные данные по профилактике грибковой инфекции у детей в контексте трансплантации гемо-поэтических стволовых клеток (ТГСК) и место вориконазола в ней. Собственный опыт представлен результатами терапии пациентов со злокачественными и незлокачественными заболеваниями в отделении трансплантации костного мозга Российской детской клинической больницы. Всего был обследован 161 пациент в возрасте от 2 до 18 лет, которые получили аллогенные или аутологичные ТГСК за период с 2012 по 2014 г. Было показано, что применение вориконазола в профилактике способствует снижению числа случаев развития грибковой инфекции, в особенности в условиях не всегда благоприятной эпидемиологической обстановки. Были проанализированы особенности профилактики и лечения данной группы заболеваний у детей.

The article presents current data on prevention of fungal infection in children in the context of hematopoietic stem cell transplantation (HSCT) and the place of voriconazole in it. Own experience shows the results of treatment of patients with malignant and non-malignant diseases in the Department of bone marrow transplantation of the Russian Children's Clinical Hospital. A total of 161 patients aged 4 to 18 years who received allogeneic or autologic HSCT for the period from 2012 to 2014 was examined. It has been shown that the application of voriconazole prophylaxis reduces the incidence of fungal infection development, particularly in conditions of not always favorable epidemiological situation. The characteristics of preventive treatment of this group of diseases in children were analyzed.

трансплантация гемопоэтических стволовых клетокинвазивная грибковая инфекцияпротивогрибковая терапиявориконазолсуспензиядетипрофилактикаhematopoietic stem cell transplantationinvasive fungal infectionantifungal therapyvoriconazolesuspensionchildrenpreventionReferencesКлимко Н.Н., Шадривова О.В., Хостелиди С.Н. и др. Инвазивный аспергиллез: результаты многоцентрового исследования. Онкогематология 2014;2:13–9. [Klimko N.N., Shadrivova O.V., Khostelidi S.N. et al. Invasive aspergillosis: results of multicenter study. Onkogematologiya = Oncohematology 2014;2:13–9. (In Russ.)].Климко Н.Н., Шадривова О.В., Хостелиди С.Н. и др. Инвазивный аспергиллез: результаты многоцентрового исследования. Онкогематология 2014;2:13–9. [Klimko N.N., Shadrivova O.V., Khostelidi S.N. et al. Invasive aspergillosis: results of multicenter study. Onkogematologiya = Oncohematology 2014;2:13–9. (In Russ.)].Wingard J.R., Carter S.L., Walsh T.J. et al. Randomized, double-blind trial of fluconazole versus voriconazole for prevention of invasive fungal infection after allogeneic hematopoietic cell transplantation. Blood 2010;116:5111–8.Wingard J.R., Carter S.L., Walsh T.J. et al. Randomized, double-blind trial of fluconazole versus voriconazole for prevention of invasive fungal infection after allogeneic hematopoietic cell transplantation. Blood 2010;116:5111–8.Marr K.A., Carter R.A., Boeckh M. et al. Invasive aspergillosis in allogeneic stem cell transplant recipients: changes in epidemiology and risk factors. Blood 2002;100(13):4358–66.Marr K.A., Carter R.A., Boeckh M. et al. Invasive aspergillosis in allogeneic stem cell transplant recipients: changes in epidemiology and risk factors. Blood 2002;100(13):4358–66.Guiot H.F., Fibbe W.E., van, t Wout J.W. Risk factors for fungal infections in patients with malignant hematologic disorders: implications for empirical therapy and prophylaxis. Clin Infect Dis 1994;18(4):525–32.Guiot H.F., Fibbe W.E., van, t Wout J.W. Risk factors for fungal infections in patients with malignant hematologic disorders: implications for empirical therapy and prophylaxis. Clin Infect Dis 1994;18(4):525–32.Thursky K., Byrnes G., Grigg A. et al. Risk factors for post-engraftment invasive aspergillosis in allogeneic stem cell transplantation. Bone Marrow Transplant 2004;34(2):115–21.Thursky K., Byrnes G., Grigg A. et al. Risk factors for post-engraftment invasive aspergillosis in allogeneic stem cell transplantation. Bone Marrow Transplant 2004;34(2):115–21.Sano H., Kobayashi R., Iguchi A. et al. Risk factor analysis of idiopathic pneumonia syndrome after allogeneic hematopoietic SCT in children. Bone Marrow Transplantation 2014;49:38–41.Sano H., Kobayashi R., Iguchi A. et al. Risk factor analysis of idiopathic pneumonia syndrome after allogeneic hematopoietic SCT in children. Bone Marrow Transplantation 2014;49:38–41.Crassard N., Hadden H., Pondarre C. et al. Invasive aspergillosis and allogeneic hematopoietic stem cell transplantation in children: a 15-year experience. Transpl Infect Dis 2008;10:177–83.Crassard N., Hadden H., Pondarre C. et al. Invasive aspergillosis and allogeneic hematopoietic stem cell transplantation in children: a 15-year experience. Transpl Infect Dis 2008;10:177–83.Mikulska M., Raiola A.M., Bruno B. et al. Risk factors for invasive aspergillosis and related mortality in recipients of allogeneic SCT from alternative donors: an analysis of 306 patients. Bone Marrow Transplant 2009;44:361–70.Mikulska M., Raiola A.M., Bruno B. et al. Risk factors for invasive aspergillosis and related mortality in recipients of allogeneic SCT from alternative donors: an analysis of 306 patients. Bone Marrow Transplant 2009;44:361–70.Srinivasan A., Wang C., Srivastava D.K. et al. Timeline, epidemiology, and risk factors for bacterial, fungal, and viral infections in children and adolescents after allogeneic hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 2013;19(1):94–101.Srinivasan A., Wang C., Srivastava D.K. et al. Timeline, epidemiology, and risk factors for bacterial, fungal, and viral infections in children and adolescents after allogeneic hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 2013;19(1):94–101.Hovi L., Saarinen-Pihkala U.M., Vettenranta K., Saxen H. Invasive fungal infections in pediatric bone marrow transplant recipients: single center experience of 10 years. Bone Marrow Transplant 2000;26:999–1004.Hovi L., Saarinen-Pihkala U.M., Vettenranta K., Saxen H. Invasive fungal infections in pediatric bone marrow transplant recipients: single center experience of 10 years. Bone Marrow Transplant 2000;26:999–1004.Benjamin D.K. Jr, Miller W.C., Bayliff S. et al. Infections diagnosed in the first year after pediatric stem cell transplantation. Pediatr Infect Dis J 2002;21:227–34.Benjamin D.K. Jr, Miller W.C., Bayliff S. et al. Infections diagnosed in the first year after pediatric stem cell transplantation. Pediatr Infect Dis J 2002;21:227–34.Crassard N., Hadden H., Pondarre C. et al. Invasive aspergillosis and allogeneic hematopoietic stem cell transplantation in children: a 15-year experience. Transpl Infect Dis 2008;10:177–83.Crassard N., Hadden H., Pondarre C. et al. Invasive aspergillosis and allogeneic hematopoietic stem cell transplantation in children: a 15-year experience. Transpl Infect Dis 2008;10:177–83.Castagnola E., Faraci M., Moroni C. et al. Invasive mycoses in children receiving hemopoietic SCT. Bone Marrow Transplant 2008;41:S107–11.Castagnola E., Faraci M., Moroni C. et al. Invasive mycoses in children receiving hemopoietic SCT. Bone Marrow Transplant 2008;41:S107–11.Kontoyiannis D.P., Marr K.A., Park B.J. et al. Prospective surveillance for invasive fungal infections in hematopoietic stem cell transplant recipients, 2001–2006: overview of the Transplant-Associated Infection Surveillance Network (TRANSNET) Database. Clin Infect Dis 2010;50(8): 1091–100.Kontoyiannis D.P., Marr K.A., Park B.J. et al. Prospective surveillance for invasive fungal infections in hematopoietic stem cell transplant recipients, 2001–2006: overview of the Transplant-Associated Infection Surveillance Network (TRANSNET) Database. Clin Infect Dis 2010;50(8): 1091–100.de Pauw B.E.. What are fungal infections? Mediterr J Hematol Infect Dis 2011;3(1):e2011001.de Pauw B.E.. What are fungal infections? Mediterr J Hematol Infect Dis 2011;3(1):e2011001.Hoenigl M., Zollner-Schwetz I., Sill H. et al. Epidemiology of invasive fungal infections and rationale for antifungal therapy in patients with haematological malignancies. Mycoses 2011;54(5):454–9.Hoenigl M., Zollner-Schwetz I., Sill H. et al. Epidemiology of invasive fungal infections and rationale for antifungal therapy in patients with haematological malignancies. Mycoses 2011;54(5):454–9.Döring M., Blume O., Haufe S. et al. Comparison of itraconazole, voriconazole, and posaconazole as oral antifungal prophylaxis in pediatric patients following allogeneic hematopoietic stem cell transplantation. Eur J Clin Microbiol Infect Dis 2014;33(4):629–38.Döring M., Blume O., Haufe S. et al. Comparison of itraconazole, voriconazole, and posaconazole as oral antifungal prophylaxis in pediatric patients following allogeneic hematopoietic stem cell transplantation. Eur J Clin Microbiol Infect Dis 2014;33(4):629–38.Yeh T.C., Liu H.C., Hou J.Y. et al. Severe infections in children with acute leukemia undergoing intensive chemotherapy can successfully be prevented by ciprofloxacin, voriconazole, or micafungin prophylaxis. Cancer 2014;120(8):1255–62.Yeh T.C., Liu H.C., Hou J.Y. et al. Severe infections in children with acute leukemia undergoing intensive chemotherapy can successfully be prevented by ciprofloxacin, voriconazole, or micafungin prophylaxis. Cancer 2014;120(8):1255–62.Drgona L., Mikula J., Bojtarova E. et al. Voriconazole in primary treatment of invasive Aspergillosis – an observational study; correlation of efficacy with C-reactive protein and procalcitonin levels. ECCMID 2014; eP360.Drgona L., Mikula J., Bojtarova E. et al. Voriconazole in primary treatment of invasive Aspergillosis – an observational study; correlation of efficacy with C-reactive protein and procalcitonin levels. ECCMID 2014; eP360.Segal B.H., Herbrecht R., Stevens D.A. et al. Defining Responses to Therapy and Study Outcomes in Clinical Trials of Invasive Fungal Diseases: Mycoses Study Group and European Organization for Research and Treatment of Cancer Consensus Criteria. CID 2008;47:674–83.Segal B.H., Herbrecht R., Stevens D.A. et al. Defining Responses to Therapy and Study Outcomes in Clinical Trials of Invasive Fungal Diseases: Mycoses Study Group and European Organization for Research and Treatment of Cancer Consensus Criteria. CID 2008;47:674–83.Barreto J.N., Beach C.L., Wolf R.C. et al. The incidence of invasive fungal infections in neutropenic patients with acute leukemia and myelodysplastic syndromes receiving primary antifungal prophylaxis with voriconazole. Am J Hematol 2013;88(4):283–8.Barreto J.N., Beach C.L., Wolf R.C. et al. The incidence of invasive fungal infections in neutropenic patients with acute leukemia and myelodysplastic syndromes receiving primary antifungal prophylaxis with voriconazole. Am J Hematol 2013;88(4):283–8.Maron G.M., Hayden R.T., Rodriguez A. et al. Voriconazole prophylaxis in children with cancer: changing outcomes and epidemiology of fungal infections. Pediatr Infect Dis J 2013;32(12):e451–5. Киргизов К.И., Шульга С.Ю., Пристанскова Е.А. и др. Энтероколит, связанный с Clostridium difficile, в детской гематологии-онкологии – решенная проблема? Обзор литературы и собственный опыт. Российский журнал детской гематологии и онкологии 2014;1:25–31. [Kirgizov K.I., Shulga S.Yu., Pristanskova Е.A. et al. Is Clostridium difficule-associated enterocolitis in pediatric hematology/oncology a solved problem? A review of literature and the authors» experience. Rossiiskiy Zhurnal Detskoi Gematologii I Onkologii = Russian Magazine of Children Hematology and Oncology 2014;1:25–31. (In Russ.)].Maron G.M., Hayden R.T., Rodriguez A. et al. Voriconazole prophylaxis in children with cancer: changing outcomes and epidemiology of fungal infections. Pediatr Infect Dis J 2013;32(12):e451–5. Киргизов К.И., Шульга С.Ю., Пристанскова Е.А. и др. Энтероколит, связанный с Clostridium difficile, в детской гематологии-онкологии – решенная проблема? Обзор литературы и собственный опыт. Российский журнал детской гематологии и онкологии 2014;1:25–31. [Kirgizov K.I., Shulga S.Yu., Pristanskova Е.A. et al. Is Clostridium difficule-associated enterocolitis in pediatric hematology/oncology a solved problem? A review of literature and the authors» experience. Rossiiskiy Zhurnal Detskoi Gematologii I Onkologii = Russian Magazine of Children Hematology and Oncology 2014;1:25–31. (In Russ.)].

The authors declare that there are no conflicts of interest present.