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      Application Value of Metagenomics Next-Generation Sequencing (mNGS) in Detection of Mucormycosis after Chemotherapy in Childhood Acute Leukemia

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          Abstract

          Objective

          To analyze the application of macrogenomics next-generation sequencing (mNGS) in the detection of postchemotherapy trichomoniasis cases in children with acute leukemia.

          Methods

          To retrospectively analyze the clinical data of 7 patients with acute leukemia combined with trichomoniasis after chemotherapy in the department of hematology and oncology of Hebei Children's Hospital, and to summarize the characteristics of their postchemotherapy clinical data, diagnostic and therapeutic processes, and outcomes.

          Results

          Among the 7 children, 6 cases had acute lymphoblastic leukemia and 1 case had acute myeloid leukemia. mNGS detected trichoderma infection, including 1 case of pulmonary cerebral type and 6 cases of pulmonary type. After treatment, 1 case died, 2 cases were cured, and 4 cases improved.

          Conclusion

          The clinical manifestations of trichomoniasis after combined chemotherapy in pediatric acute leukemia lack specificity. Early application of the mNGS assay is of great value.

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          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

          Oliver Cornely, Ana Alastruey-Izquierdo, Dorothee Arenz … (2019)
          Mucormycosis is a difficult to diagnose rare disease with high morbidity and mortality. Diagnosis is often delayed, and disease tends to progress rapidly. Urgent surgical and medical intervention is lifesaving. Guidance on the complex multidisciplinary management has potential to improve prognosis, but approaches differ between health-care settings. From January, 2018, authors from 33 countries in all United Nations regions analysed the published evidence on mucormycosis management and provided consensus recommendations addressing differences between the regions of the world as part of the "One World One Guideline" initiative of the European Confederation of Medical Mycology (ECMM). Diagnostic management does not differ greatly between world regions. Upon suspicion of mucormycosis appropriate imaging is strongly recommended to document extent of disease and is followed by strongly recommended surgical intervention. First-line treatment with high-dose liposomal amphotericin B is strongly recommended, while intravenous isavuconazole and intravenous or delayed release tablet posaconazole are recommended with moderate strength. Both triazoles are strongly recommended salvage treatments. Amphotericin B deoxycholate is recommended against, because of substantial toxicity, but may be the only option in resource limited settings. Management of mucormycosis depends on recognising disease patterns and on early diagnosis. Limited availability of contemporary treatments burdens patients in low and middle income settings. Areas of uncertainty were identified and future research directions specified.
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            The epidemiology and clinical manifestations of mucormycosis: a systematic review and meta-analysis of case reports

            W Jeong, C Keighley, R Wolfe … (2019)
            The epidemiology of mucormycosis in the era of modern diagnostics is relatively under-explored.
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              Pediatric acute lymphoblastic leukemia

              Hiroto Inaba, Charles Mullighan (2020)
              The last decade has witnessed great advances in our understanding of the genetic and biological basis of childhood acute lymphoblastic leukemia (ALL), the development of experimental models to probe mechanisms and evaluate new therapies, and the development of more efficacious treatment stratification. Genomic analyses have revolutionized our understanding of the molecular taxonomy of ALL, and these advances have led the push to implement genome and transcriptome characterization in the clinical management of ALL to facilitate more accurate risk-stratification and, in some cases, targeted therapy. Although mutation- or pathway-directed targeted therapy (e.g., using tyrosine kinase inhibitors to treat Philadelphia chromosome [Ph]-positive and Phlike B-cell-ALL) is currently available for only a minority of children with ALL, many of the newly identified molecular alterations have led to the exploration of approaches targeting deregulated cell pathways. The efficacy of cellular or humoral immunotherapy has been demonstrated with the success of chimeric antigen receptor T-cell therapy and the bispecific engager blinatumomab in treating advanced disease. This review describes key advances in our understanding of the biology of ALL and optimal approaches to risk-stratification and therapy, and it suggests key areas for basic and clinical research.
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                Author and article information

                Contributors
                Li Wang:
                ORCID: https://orcid.org/0000-0003-3773-8626
                Journal
                Journal ID (nlm-ta): Evid Based Complement Alternat Med
                Journal ID (iso-abbrev): Evid Based Complement Alternat Med
                Journal ID (publisher-id): ECAM
                Title: Evidence-based Complementary and Alternative Medicine : eCAM
                Publisher: Hindawi
                ISSN (Print): 1741-427X
                ISSN (Electronic): 1741-4288
                Publication date Collection: 2022
                Publication date (Electronic): 19 August 2022
                Publication date PMC-release: 19 August 2022
                Volume: 2022
                Electronic Location Identifier: 7366432
                Affiliations
                1Department of Hematology and Oncology, Hebei Province Children's Hospital, Shijiazhuang City 050031, Hebei Province, China
                2Hebei Province Children's Hospital Orthopedics Department, Shijiazhuang City 050031, Hebei Province, China
                Author notes

                Academic Editor: Shuli Yang

                Author information
                https://orcid.org/0000-0003-3773-8626
                Article
                DOI: 10.1155/2022/7366432
                PMC ID: 9417758
                PubMed ID: 36034963
                SO-VID: b0de0b80-38c9-40c1-bfde-69541340173b
                Copyright © Copyright © 2022 Wenzi Li et al.
                License:

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 10 June 2022
                Date accepted : 15 July 2022
                Funding
                Funded by: Hebei Province Medical Science Research Project Planning Fund
                Award ID: 20211015
                Categories
                Subject: Research Article

                ScienceOpen disciplines: Complementary & Alternative medicine
                Data availability:
                ScienceOpen disciplines: Complementary & Alternative medicine

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