文献综述

儿童造血干细胞移植后毛霉菌病临床诊疗进展

  • 习必鑫 ,
  • 胡群 ,
  • 赵馨 综述 ,
  • 刘爱国 审校
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  • 华中科技大学同济医学院附属同济医院儿童血液科(湖北武汉 430030)

收稿日期: 2022-01-05

  网络出版日期: 2023-04-07

基金资助

国家自然科学基金项目(81874187);国家自然科学基金项目(81472706)

Research advances of the diagnosis and management for mucormycosis following hematopoietic stem cell transplant in children

  • Bixin Reviewer: XI ,
  • Qun HU ,
  • Xin ZHAO ,
  • Aiguo Reviser: LIU
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  • Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China

Received date: 2022-01-05

  Online published: 2023-04-07

摘要

儿童毛霉菌病是造血干细胞移植后罕见的严重并发症之一。免疫功能抑制、中性细胞减少症、移植物抗宿主病、铁负荷过载、静脉高营养、糖皮质激素及钙调神经磷酸酶抑制剂使用等多种危险因素与儿童造血干细胞移植后毛霉菌病的发生密切相关。由于儿童移植后毛霉菌病侵袭进展迅速,其临床诊疗极具挑战性。文章综述儿童造血干细胞移植后毛霉菌病的流行病学特点、发病机制、诊断及治疗的研究进展,为进一步完善适用于儿童移植后毛霉菌病的诊疗规范提供建议。

本文引用格式

习必鑫 , 胡群 , 赵馨 综述 , 刘爱国 审校 . 儿童造血干细胞移植后毛霉菌病临床诊疗进展[J]. 临床儿科杂志, 2023 , 41(4) : 311 -315 . DOI: 10.12372/jcp.2023.22e0025

Abstract

The pediatric mucormycosis is a rare but often highly lethal complication after hematopoietic stem cell transplantation (HSCT). Of the hazard factors, immunosuppression post HSCT, neutropenia, graft-versus-host disease (GVHD), Iron overload, parenteral hyperalimentation, and the use of corticosteroid or calcineurin inhibitors, particularly in children, have been reported to be the commonest contributions to mucormycosis. An early diagnosis and combined treatment of mucormycosis is challenging due to the nature of often rapidly invasion and destruction. This article reviews the research advances in epidemiological characteristics, pathogenesis, diagnosis and treatment of mucormycosis in children after HSCT, and provides suggestions for further improvement of the diagnosis and treatment of mucormycosis in children after transplantation.

参考文献

[1] Hassan MIA, Voigt K. Pathogenicity patterns of mucormycosis: epidemiology, interaction with immune cells and virulence factors[J]. Med Mycol, 2019, 57(Suppl 2): S245-S256.
[2] Cornely OA, Alastruey-Izquierdo A, Arenz D, et al. Global guideline for the diagnosis and management of mucormycosis: an initiative of the European Confederation of Medical Mycology in cooperation with the Mycoses Study Group Education and Research Consortium[J]. Lancet Infect Dis, 2019, 19(12): e405-e421.
[3] Francis JR, Villanueva P, Bryant P, et al. Mucormycosis in children: review and recommendations for management[J]. J Pediatr Infect Dis Soc, 2018, 7(2): 159-164.
[4] Gebremariam T, Liu M, Luo G, et al. CotH3 mediates fungal invasion of host cells during mucormycosis[J]. J Clin Invest, 2014, 124(1): 237-250.
[5] Pana ZD, Seidel D, Skiada A, et al. Invasive mucormycosis in children: an epidemiologic study in European and non-European countries based on two registries[J]. BMC Infect Dis, 2016, 16(1): 667.
[6] Skiada A, Lass-Floerl C, Klimko N, et al. Challenges in the diagnosis and treatment of mucormycosis[J]. Med Mycol, 2018, 56(Suppl 1): 93-101.
[7] Jeong W, Keighley C, Wolfe R, et al. The epidemiology and clinical manifestations of mucormycosis: a systematic review and meta-analysis of case reports[J]. Clin Microbiol Infect, 2019, 25(1): 26-34.
[8] Tissot F, Agrawal S, Pagano L, et al. ECIL-6 guidelines for the treatment of invasive candidiasis, aspergillosis and mucormycosis in leukemia and hematopoietic stem cell transplant patients[J]. Haematologica, 2017, 102(3): 433-444.
[9] Jeong W, Keighley C, Wolfe R, et al. Contemporary management and clinical outcomes of mucormycosis: a systematic review and meta-analysis of case reports[J]. Int J Antimicrob Agents, 2019, 53(5): 589-597.
[10] 梁官钊, 刘维达. 2019年欧洲毛霉病诊疗指南解读[J]. 中国真菌学杂志, 2021, 16(2): 116-120.
[11] Lanternier F, Poiree S, Elie C, et al. Prospective pilot study of high-dose (10 mg/kg/day) liposomal amphotericin B (L-AMB) for the initial treatment of mucormycosis[J]. J Antimicrob Chemother, 2015, 70(11): 3116-3123.
[12] Marty FM, Ostrosky-Zeichner L, Cornely OA, et al. Isavuconazole treatment for mucormycosis: a single-arm open-label trial and case-control analysis[J]. Lancet Infect Dis, 2016, 16(7): 828-837.
[13] Kyvernitakis A, Torres HA, Jiang Y, et al. Initial use of combination treatment does not impact survival of 106 patients with haematologic malignancies and mucormycosis: a propensity score analysis[J]. Clin Microbiol Infect, 2016, 22(9): 811.
[14] Marty FM, Cornely OA, Mullane KM, et al. Isavuconazole for treatment of invasive fungal diseases caused by more than one fungal species[J]. Mycoses, 2018, 61(7): 485-497.
[15] Bhatnagar S, Mukherjee D, Salem AH, et al. Dose adjustment of venetoclax when co-administered with posaconazole: clinical drug-drug interaction predictions using a PBPK approach[J]. Cancer Chemother Pharmacol, 2021, 87(4): 465-474.
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