Population and Study Design
This retrospective observational study included children ≤ 21 years
diagnosed at Texas Children’s Hospital (TCH) with ALL, AML, or lymphoma
between 2006 and 2019, and who had a proven or probable IMI diagnosed
between January 1, 2006 and June 30, 2020. Recipients of HSCT who
developed IMI post-HSCT were excluded. The TCH antifungal algorithm was
implemented in January 2016, and comparisons were made between time
periods of January 2006 through December 2015, and January 2016 through
June 2020. Potential cases were identified by the TCH Health Information
Management (HIM) team using ICD9 codes that included ALL and AML (ICD9
204-208), lymphoma (ICD9 200-202), and fungal disease (ICD9 117-118,
421, 518.89, 530.19, 730.2, 739.19). The study was approved by the
Baylor College of Medicine institutional review board.