This is a single-center, single-arm, observational clinical study evaluating the efficacy and safety of low-dose liposomal amphotericin B (1 mg/kg/day, intravenous, once daily) for the prevention of invasive fungal infections in children aged 3-17 years with hematological malignancies who develop prolonged neutropenia (absolute neutrophil count ≤ 0.5×10^9/L, expected to last > 7 days) and are at high risk for invasive fungal disease. Participants are those who, per the treating physician's routine clinical decision, have been initiated on liposomal amphotericin B prophylaxis at 1 mg/kg/day due to intolerance or toxicity to other antifungal agents. The primary outcome is the incidence of proven or probable invasive fungal disease. Secondary outcomes include incidence of pneumonia, persistent unexplained fever >4 days, use of additional systemic antifungal therapy, and adverse events. A total of 30 participants will be enrolled. Data will be collected at baseline, during treatment, and within 7 days after treatment completion.
Inclusion Criteria:
Note (a): For these heterogeneous diseases, myeloablative therapy must be met; if neutropenia >7 days is not met, the patient should be excluded.
Note (b): Agranulocytosis is defined as absolute neutrophil count ≤0.5×10^9/L, or absolute neutrophil count ≤1×10^9/L with expected decline to ≤0.5×10^9/L within 48 hours.
Exclusion Criteria:
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Children with thalassemia undergoing allogeneic hematopoietic stem cell transplantation who meet high-risk criteria for invasive fungal disease per NCCN 2025 V1 guidelines, with expected neutropenia \>7 days (absolute neutrophil count ≤0.5×10\^9/L). Participants receive liposomal amphotericin B at 1 mg/kg/day, intravenous, once daily, as antifungal prophylaxis initiated by the treating physician in routine clinical practice due to intolerance or toxicity to other antifungal agents.
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