Mucormycosis in Paediatric Patients After Haematopoietic Stem Cell Transplantation: A Systematic Review and Meta‐Analysis

Background Data on the epidemiology, diagnostic methods and evidence‐based recommended treatment methods for children with mucormycosis who have undergone Haematopoietic stem cell transplantation (HSCT) are limited. Objective Summarise past recommendations and the latest literature on the treatment of HSCT in children with mucorin infection and clarify the epidemiology, diagnosis, treatment and outcomes of this invasive fungal disease. Methods A comprehensive search for full‐text studies involving humans that were published in English between January 2000 and December 2022 was conducted in Ovid MEDLINE and Ovid Embase using various key words and MeSH terms. Results A total of 951 articles were identified in the initial database search, of which 28 (32 individual patients) were included in the final analysis. The majority of HSCT recipients (14/26, 54%) had a diagnosis of mucormycosis within 30 days posttransplant, with a median time from transplant to diagnosis of 19 (27 patients; IQR, 13–213) days. Pulmonary mucormycosis (9/32, 28%) and disseminated mucormycosis (9/32, 28%) were the most commonly observed manifestations in paediatric patients after HSCT. Targeted antifungal therapy was used in 27 patients. Iv AmB formulations were the most commonly administered first‐line treatment (26/27, 96%). Compared with iv AmB monotherapy, initial treatment with combination antifungal therapy appeared to improve all‐cause mortality [3/10 (30%) vs. 6/17 (35%)]. Conclusions The results of the present review will help to determine the pathology, diagnosis, treatment and outcomes of this invasive fungal disease.