{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T13:59:13Z","timestamp":1792159153471,"version":"4.4.0"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:00:00Z","timestamp":1792108800000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Invasive mold infections (IMI) are life-threatening complications during treatment for pediatric acute leukemia. Population-based data on IMI incidence, timing, and outcomes during first-line therapy remain limited. We aimed to provide a nationwide epidemiological overview of IMI during first-line treatment of pediatric acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL) and explore potential treatment-related risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective nationwide cohort study of all children (&amp;lt;18 years) initiating first-line chemotherapy for AML or ALL in Denmark during 2008\u20132022. IMIs were classified as proven or probable according to 2020 EORTC\/MSGERC criteria by review of microbiology, imaging, pathology, and chart data. Follow-up covered first-line chemotherapy. Competing risk\u2013adjusted cumulative incidence of IMI was estimated, risk factors were evaluated using Cox regression, and survival after IMI was analyzed using the Kaplan\u2013Meier method.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 621 patients, 43 (6.9%) developed IMI: 14\/90 (15.6%) with AML and 29\/531 (5.5%) with ALL. In adjusted Cox regression, AML was associated with higher IMI hazard than ALL (HR 5.6, 95% CI 2.6 to 12.1), whereas no other prespecified risk factors were independently associated with IMI. Incidence rates were 38.6 per 100 patient-years in AML and 2.7 in ALL. Nearly half of IMIs occurred beyond 90 days after initiation of first-line chemotherapy. Four patients experienced a second distinct IMI episode; Aspergillus species accounted for 37\/47 (79%) episodes and non-Aspergillus molds for 10\/47 (21%). IMI-associated death occurred in 10 patients (1.6% of the cohort), yielding a case fatality rate of 23% among IMI cases; IMI was present in 43% of all deaths.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this nationwide cohort, IMI occurred more frequently than reported in many previous pediatric studies, particularly in AML. IMIs were observed throughout first-line therapy, despite antifungal prophylaxis, and were associated with substantial mortality, emphasizing the need for sustained clinical vigilance beyond induction.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jpids\/piag112","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T11:54:07Z","timestamp":1792065247000},"source":"Crossref","is-referenced-by-count":0,"title":["Incidence and Risk Factors for Invasive Mold Infections in Children During First-Line Chemotherapy for Primary Acute Leukemia: A National Retrospective Cohort Study"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4085-0969","authenticated-orcid":false,"given":"Rasmus Moeller","family":"Duus","sequence":"first","affiliation":[{"name":"Hans Christian Andersen Children's Hospital, Odense University Hospital , Odense ,","place":["Denmark"]},{"name":"Department of Molecular Medicine, University of Southern Denmark , Odense ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma Soendergaard","family":"Joergensen","sequence":"additional","affiliation":[{"name":"Hans Christian Andersen Children's Hospital, Odense University Hospital , Odense ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emil Bach","family":"Offendal","sequence":"additional","affiliation":[{"name":"Hans Christian Andersen Children's Hospital, Odense University Hospital , Odense ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadja Hawwa","family":"Vissing","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Adolescent Medicine, Rigshospitalet , Copenhagen ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristian Loevvik","family":"Juul-Dam","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital , Aarhus ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2129-328X","authenticated-orcid":false,"given":"Flemming Schoenning","family":"Rosenvinge","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark , Odense ,","place":["Denmark"]},{"name":"Department of Clinical Microbiology, Odense University Hospital , Odense ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorthe","family":"Grosen","sequence":"additional","affiliation":[{"name":"Hans Christian Andersen Children's Hospital, Odense University Hospital , Odense ,","place":["Denmark"]},{"name":"Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark , Odense ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina Marie","family":"Birk","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Aalborg University Hospital , Aalborg ,","place":["Denmark"]},{"name":"Clinical Institute, Aalborg University , Aalborg ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katja Majlund","family":"Harder","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Aalborg University Hospital , Aalborg ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6286-2496","authenticated-orcid":false,"given":"Steffen","family":"Husby","sequence":"additional","affiliation":[{"name":"Hans Christian Andersen Children's Hospital, Odense University Hospital , Odense ,","place":["Denmark"]},{"name":"Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark , Odense ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesper Bonnet","family":"Moeller","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine, University of Southern Denmark , Odense ,","place":["Denmark"]},{"name":"Danish Institute for Advanced Study, University of Southern Denmark , Odense ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin","family":"Christensen","sequence":"additional","affiliation":[{"name":"Section for Biostatistics and Evidence-Based Research, the Parker Institute, Bispebjerg and Frederiksberg Hospital , Copenhagen ,","place":["Denmark"]},{"name":"Research Unit of Rheumatology, Department of Clinical Research, University of Southern Denmark, Odense University Hospital , Odense ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise Aarup","family":"Duus","sequence":"additional","affiliation":[{"name":"Department of Radiology, Odense University Hospital , Odense ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7533-3112","authenticated-orcid":false,"given":"Mathias","family":"Rathe","sequence":"additional","affiliation":[{"name":"Hans Christian Andersen Children's Hospital, Odense University Hospital , Odense ,","place":["Denmark"]},{"name":"Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark , Odense ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,10,16]]},"container-title":["Journal of the Pediatric Infectious Diseases Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jpids\/advance-article-pdf\/doi\/10.1093\/jpids\/piag112\/72043880\/piag112.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jpids\/advance-article-pdf\/doi\/10.1093\/jpids\/piag112\/72043880\/piag112.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T13:43:23Z","timestamp":1792158203000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jpids\/advance-article\/doi\/10.1093\/jpids\/piag112\/8931544"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,16]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1093\/jpids\/piag112","relation":{},"ISSN":["2048-7207"],"issn-type":[{"value":"2048-7207","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,16]]},"article-number":"piag112"}}