Alpha Hemolytic Streptococcal Infection During Intensive Treatment for Acute Myeloid Leukemia: A Report From the Children’s Cancer Group Study CCG-2891

Gamis, Alan S.; Howells, William B.; DeSwarte-Wallace, Joetta; Feusner, James; Buckley, Jonathan D.; Woods, William G.

doi:10.1200/jco.2000.18.9.1845

Cited by 78 publications

(67 citation statements)

References 20 publications

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“…There were 3 major differences between the 2 regimens that might explain these findings, namely, the presence of fludarabine, higher daily dose of idarubicin, and higher daily dose of cytarabine associated with the fludarabine-based regimen (although the cumulative doses of idarubicin and cytarabine were similar). Given previous reports that have found that high-dose cytarabine is a risk factor for invasive viridans group streptococcal infections, [8][9][10][11][12][13] it seems that the latter may be the more likely etiologic factor behind worse infection outcomes associated with the fludarabine regimen.…”

Section: Discussionmentioning

confidence: 99%

Microbiologically documented infections and infection-related mortality in children with acute myeloid leukemia

Sung

Lange

Gerbing

et al. 2007

Blood

188

177

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Section: Discussionmentioning

confidence: 99%

Microbiologically documented infections and infection-related mortality in children with acute myeloid leukemia

Sung

Lange

Gerbing

et al. 2007

Blood

188

177

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“…17 However, the better diseasefree survival rate in children under age 2 years is encouraging. Together these findings suggest that younger children may have BLOOD, 15 SEPTEMBER 2001 ⅐ VOLUME 98, NUMBER 6 For personal use only.…”

Section: Discussionmentioning

confidence: 99%

Relationships between age at diagnosis, clinical features, and outcome of therapy in children treated in the Medical Research Council AML 10 and 12 trials for acute myeloid leukemia

Webb

Harrison

Stevens

et al. 2001

Blood

124

107

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children were treated in the Medical Research Council acute myeloid leukemia 10 and 12 trials. The presenting features and outcomes of therapy in these children were compared by age. Although there was no single cutoff in age, younger children were more likely to have intermediate risk and less likely to have favorable cytogenetics (P < .001), and they had a higher incidence of translocations involving chromosome 11q23 (P < .001). The distribution of French-American-British (FAB) types also varied with age; FAB types M5 (P < .001) and M7 (P < .001) were more common in early childhood, whereas older children were more likely to have FAB types M0 (P ‫؍‬ .03), M1 (P ‫؍‬ .04), M2 (P ‫؍‬ .005), and M3 (P < .001). Involvement of the central nervous system at diagnosis was also more common in the youngest children (P ‫؍‬ .01). Younger children had more severe diarrhea (P ‫؍‬ .002), whereas older children had worse nausea and vomiting (P ‫؍‬ .01) after chemotherapy. When adjusted for other important factors, complete remission rates were similar (P ‫؍‬ .5) and although there was less resistant disease in younger children (P ‫؍‬ .003), this was partially balanced by a slight increase in deaths during induction therapy in younger patients (P ‫؍‬ .06). On multivariate analysis overall survival (P ‫؍‬ .02), event-free survival (P ‫؍‬ .02), and diseasefree survival were better (P ‫؍‬ .06) in younger children due to a lower relapse rate (P ‫؍‬ .02) especially in the bone marrow (P ‫؍‬ .02). (Blood. 2001;98:1714-1720)

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“…20 In children treated for AML, there was an association between the presence of gastrointestinal toxicity and the development of viridans group streptococcal bacteraemia. 21 Similarly, coagulase-negative staphylococci have been assumed to originate from central venous catheters. However, there is a growing body of evidence that these bacteria may, in fact, also originate from the gastrointestinal tract.…”

Section: Discussionmentioning

confidence: 99%

Bacteraemia coincides with low citrulline concentrations after high-dose melphalan in autologous HSCT recipients

Herbers

Blijlevens

Donnelly

et al. 2008

Bone Marrow Transplant

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Mucosal damage to the intestines induced by myeloablative conditioning for allogeneic PBSC transplant (PBSCT) can be determined by the concentration of citrulline, which is a functional marker of small intestinal enterocytes. Low citrulline concentrations in blood coincide with and are a response to severe mucosal barrier injury. We treated 29 patients with high-dose melphalan 200 mg/m 2 (Mel-200) to prepare for an autologous PBSCT and collected plasma samples from each patient starting before the myeloablative regimen and three times per week thereafter until discharge. The baseline citrulline concentration was 27.6 mM±4.0 (mean±95% confidence interval; CI), and citrulline concentrations declined rapidly thereafter reaching a nadir averaging 6.7 mM ± 2.7, 12 days after starting Mel-200. Citrulline concentrations, only increased gradually and were still low (12 mM ± 4) at discharge. A total of 20 patients developed fever, which was associated with bacteraemia in 10 cases. Their mean citrulline concentrations were lower at 5.5 mM ± 1.5 than were those of patients without bacteraemia (10.2 mM ± 3.9). Importantly, neither the number of preceding neutropenic days nor the mean C-reactive protein (CRP) concentration at the onset of fever was different between these two groups. In conclusion, citrulline concentrations rapidly decline after Mel-200 reflecting intestinal mucosal barrier injury. Low citrulline, rather than the duration of neutropenia, is associated with bacteraemia indicating the importance of an intact mucosal barrier in neutropenic patients.

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Alpha Hemolytic Streptococcal Infection During Intensive Treatment for Acute Myeloid Leukemia: A Report From the Children’s Cancer Group Study CCG-2891

Cited by 78 publications

References 20 publications

Microbiologically documented infections and infection-related mortality in children with acute myeloid leukemia

Microbiologically documented infections and infection-related mortality in children with acute myeloid leukemia

Relationships between age at diagnosis, clinical features, and outcome of therapy in children treated in the Medical Research Council AML 10 and 12 trials for acute myeloid leukemia

Bacteraemia coincides with low citrulline concentrations after high-dose melphalan in autologous HSCT recipients

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