Infections are an important cause for morbidity and mortality in pediatric acute myeloid leukemia (AML). We therefore characterized infectious complications in children treated according to the trial AML-BFM 2004. Patients with Down syndrome were excluded from the analysis. Data were gathered from the medical records in the hospital where the patients were treated. A total of 405 patients (203 girls; median age 8.4 years) experienced 1326 infections. Fever without identifiable source occurred in 56.1% of the patients and clinically and microbiologically documented infections in 17.5% and 32.4% of the patients, respectively. In all, 240 Gram-positive (112 viridans group streptococci) and 90 Gram-negative isolates were recovered from the bloodstream. Invasive fungal infection was diagnosed in 3% of the patients. Three children each died of Gram-negative bacteremia and invasive aspergillosis, respectively. As compared with the results of AML-BFM 93 with lower dose intensity, infection-related morbidity was slightly higher in AML-BFM 2004 (3.3. versus 2.8 infections per patient), whereas infection-related mortality significantly decreased (1.5% versus 5.4% P=0.003). Specific anti-infective recommendations included in the treatment protocol, regular training courses for pediatric hematologists and increasing experience may be the reason for reduced infection-related mortality in children with AML. Further studies are needed to decrease infection-related morbidity.

Our data demonstrate that a reduced-intensity chemotherapeutic regimen in children with AML and Down syndrome is still associated with high morbidity. Although no patient died due to bacteria or fungi, viruses were responsible for all lethal events. Future studies, therefore, have to focus on the impact of viruses on morbidity and mortality of patients with AML and Down syndrome.

Ein Kind, das zu ertrinken droht, und ein Kameramann, der nicht eingreift -mit dieser Szene aus dem dokumentarischen Film ,Honey Land' (2019) 2 hatte Timo Heimerdinger (Freiburg) einen bewusst drastischen Einstieg gewählt. Die Tagungsteilnehmer*innen waren sich einig: Der Kameramann hätte sein Konzept aufgeben müssen, um dem Kind zu helfen. Die Auseinandersetzung damit, dass (und warum) er genau das nicht getan hat, katapultierte die Teilnehmer*innen direkt ins Feld der Positio-1 Der Bericht ist die an das Stylesheet der ZEKW angepasste sowie geringfügig textlich bearbeitete Zweitveröffentlichung des Textes, der zuerst in Heft 2/2022 der Österreichischen Zeitschrift für Volkskunde erschienen ist. 2 Stefanov, Ljubomir und Tamara Kotevska. 2019. Honey Land. Nordmazedonien.

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