Epidemiological characteristics of invasive fungal infection after allogeneic hematopoietic stem cell transplantation in children and advances in prevention

Invasive fungal infection (IFI) is a severe complication following allogeneic hematopoietic stem cell transplantation (allo-HSCT) in children, posing significant threats to patient prognosis. The epidemiology of IFI varies due to multiple influencing factors. Its occurrence risk is associated with various host-related factors as well as environmental and economic conditions. Primary and secondary antifungal prevention constitute the main prevention strategies. The selection of antifungal drugs requires a balance between efficacy and safety. Although traditional and novel antifungal drugs offer preventive options, their potential side effects, drug interactions and resistance issues demand attention. Risk-stratified prevention strategies, by identifying high-risk children and implementing targeted interventions, can enhance prevention efficacy while avoiding unnecessary drug exposure in low-risk patients. However, current prevention strategies still face challenges such as drug toxicity, cost effectiveness and insufficient child-specific evidence. This review systematically summarizes the epidemiological characteristics, risk factors, current prevention strategies and emerging perspectives in the field of IFI in patients after allo-HSCT.