Review ArticlesFrequency and Determinants of Invasive Fungal Infections in Children With Solid and Hematologic Malignancies in a Nonallogeneic Stem Cell Transplantation Setting: A Narrative ReviewRuijters, Veerle J. BSc*,†; Oosterom, Natanja MD*; Wolfs, Tom F.W. MD, PhD‡; van den Heuvel-Eibrink, Marry M. MD, PhD*; van Grotel, Martine MD, PhD*Author Information *Princess Máxima Center for Pediatric Oncology †Faculty of Medicine, University Medical Center Utrecht ‡Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, The Netherlands The authors declare no conflict of interest. Reprints: Martine van Grotel, MD, PhD, Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands (e-mail: [email protected]). Journal of Pediatric Hematology/Oncology: July 2019 - Volume 41 - Issue 5 - p 345-354 doi: 10.1097/MPH.0000000000001468 Buy SDC Metrics Abstract Invasive fungal infections (IFIs) are an important cause of morbidity and mortality in children with cancer. An overview of studies on the frequency and determinants of IFI in pediatric oncology patients in nonallogeneic stem cell transplantation settings is lacking. We performed a literature review in Pubmed and Embase, and included 13 prospective and 23 retrospective studies. The IFI frequency (proven/probable based on EORTC criteria) in nonallogeneic stem cell transplantation pediatric cancer patients ranged between 1.0% and 38.0%, with the highest frequencies reported in hematologic malignancies. The most common fungal species seen in the studied population was Candida, followed by Aspergillus. IFI are not well investigated in solid tumor patients. Significant recurrent determinants from univariate analysis were the diagnosis acute myeloid leukemia, (prolonged) neutropenia and an older age (above 10 years). The only 2 significant determinants based on multivariate analysis were the preceding number of days of broad-spectrum antibiotics (odds ratio, 1.05; 95% confidence interval, 1.02-1.07; P=0.0006) and the number of days of corticosteroids (odds ratio, 1.05; 95% confidence interval, 1.02-1.09; P=0.005), that were both based on a group of acute myeloid leukemia patients only. Future studies are necessary to determine the frequency and determinants of IFI in pediatric oncology including a representative number of solid tumor patients. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.