Evidence map›Paper›PMID 32459599›Full record

GuidelineJournal of clinical oncology : official journal of the American Society of Clinical Oncology2020

Clinical Practice Guideline for Systemic Antifungal Prophylaxis in Pediatric Patients With Cancer and Hematopoietic Stem-Cell Transplantation Recipients.

Thomas Lehrnbecher, Brian T Fisher, Bob Phillips, Melissa Beauchemin, Fabianne Carlesse, Elio Castagnola, Nathan Duong, L Lee Dupuis, Vicky Fioravantti, Andreas H Groll and 9 more

Open access · hybridAbstract readPractice Guideline
In one paragraph

Guideline in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 71 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
71citing papers in PubMed, 5 pooled it
1.7field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

71 citing papers in PubMed, 5 syntheses or guidelines pooled it, 133 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Guideline
  4. Pooled it
  5. Brazilian guidelines for the diagnosis and treatment of candidemia and invasive candidiasis in adults and children.The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases
    Guideline
  6. Trial
  7. First report ofMedical mycology case reports · 2026
    Article
  8. Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Article
  16. Targeting multidrug-resistantMaterials today. Bio · 2026
    Article
  17. Review
  18. Fungal Infections in Pediatric Patients With Hematologic Malignancies and Stem Cell Transplantation: Impact on the Upper and Lower Respiratory Systems.The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale · 2026
    Review
  19. Article
  20. Article

11 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors at 16 institutions in 9 countries.

Thomas LehrnbecherDivision of Pediatric Hematology and Oncology, Hospital for Children and Adolescents, University Hospital, Johann Wolfgang Goethe University, Frankfurt am Main, Germany.
Brian T FisherDivision of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, PA.
Bob PhillipsDepartment of Hematology and Oncology, Leeds Teaching Hospital, National Health Service Trust, Leeds, United Kingdom.
Melissa BeaucheminColumbia University/Herbert Irving Cancer Center, Pediatric Oncology, New York, NY.
Fabianne CarlessePediatric Oncology Institute, GRAACC/Federal University of Sao Paulo, Sao Paulo, Brazil.
Elio CastagnolaInfectious Diseases Unit, Department of Pediatrics, Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Giannina Gaslini, Genova, Italy.
Nathan DuongMedical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
L Lee DupuisChild Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada.
Vicky FioravanttiDivision of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada.
Andreas H GrollInfectious Disease Research Program, Center for Bone Marrow Transplantation, Department of Pediatric Hematology/Oncology, University Children's Hospital, Muenster, Germany.
Gabrielle M HaeuslerDepartment of Infectious Diseases, Peter MacCallum Cancer Centre and Royal Children's Hospital, Melbourne, and National Health and Medical Research Council, National Centre for Infections in Cancer, Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia.
Emmanuel RoilidesInfectious Diseases Unit, Third Department of Pediatrics, Aristotle, University School of Health Sciences, Hippokration General Hospital, Thessaloniki, Greece.
Michelle ScienceDivision of Infectious Diseases, The Hospital for Sick Children, Toronto, Ontario, Canada.
William J SteinbachDivision of Pediatric Infectious Diseases, Duke University Medical Center, Durham, NC.
Wim TissingDepartment of Pediatric Oncology, Princess Maxima Centre, Utrecht, and Department of Pediatric Oncology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Adilia WarrisMedical Research Council Center for Medical Mycology, University of Exeter, Exeter, and Great Ormond Street Hospital, London, United Kingdom.
Priya PatelPediatric Oncology Group of Ontario, Toronto, Ontario, Canada.
Paula D RobinsonPediatric Oncology Group of Ontario, Toronto, Ontario, Canada.
Lillian SungChild Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada.
Hospital for Sick Children · CAPediatric Oncology Group · CAChildren's Hospital of Philadelphia · USColumbia University · USDuke Medical Center · USGoethe University Frankfurt · DEHippocration General Hospital · GRInstitute for Clinical Evaluative Sciences · CAIstituto Giannina Gaslini · ITMedical Research Council · GBNational Health Service · GBPeter MacCallum Cancer Centre · AUPrincess Margaret Cancer Centre · CASickKids Foundation · CAUniversidade Federal de São Paulo · BRUniversity of Groningen · NL

Funding

Department of Health PDF-2014-07-072Medical Research Council G0800472Medical Research Council MR/N006364/2Wellcome TrustWellcome Trust 097377
6 · The paper itself

Abstract

purposeTo develop a clinical practice guideline for systemic antifungal prophylaxis in pediatric patients with cancer and hematopoietic stem-cell transplantation (HSCT) recipients.

methodsRecommendations were developed by an international multidisciplinary panel that included a patient advocate. We conducted a systematic review of systemic antifungal prophylaxis in children and adults with cancer and HSCT recipients. The Grading of Recommendations Assessment, Development, and Evaluation approach was used to make strong or weak recommendations and to classify level of evidence as high, moderate, low, or very low. The panel considered directness of the data to pediatric patients.

resultsThere were 68 randomized trials included in the systematic review, of which 6 (9%) were conducted in a solely pediatric population. Strong recommendations were made to administer systemic antifungal prophylaxis to children and adolescents receiving treatment of acute myeloid leukemia, to those undergoing allogeneic HSCT pre-engraftment, and to those receiving systemic immunosuppression for graft-versus-host disease treatment. A strong recommendation was made to administer a mold-active agent with an echinocandin or a mold-active azole when systemic antifungal prophylaxis is warranted. For children younger than 13 years of age, an echinocandin, voriconazole, or itraconazole is suggested. Posaconazole may also be used in those age 13 years or older. A strong recommendation against routine administration of amphotericin as systemic antifungal prophylaxis was made.

conclusionWe developed a clinical practice guideline for systemic antifungal prophylaxis administration in pediatric patients with cancer and HSCT recipients. Implementation and assessment of guideline-concordant rates and impacts are important future steps.

Indexed as

Antibiotic ProphylaxisHematopoietic Stem Cell TransplantationAdolescentAntifungal AgentsChildChild, PreschoolHumansImmunosuppression TherapyInfantInfant, NewbornInvasive Fungal InfectionsLeukemia, Myeloid, AcuteNeoplasmsPatient SelectionPrecursor Cell Lymphoblastic Leukemia-LymphomaSystematic Reviews as TopicAntifungal Agents

Identifiers

PMID32459599
PMCPMC7499615
OpenAlexW3030494473

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.