Infections Occurring During the Courses of Anticancer Chemotherapy in Children with All: A Retrospective Analysis of 59 Patients

Abstract

In a retrospective analysis we evaluated the occurrence of infections in 59 children with acute lymphoblastic leukemia (ALL) during the entire duration of their anticancer chemotherapy. We recorded a total of 245 infection episodes, 118 (50%) being during neutropenia and 119 (50%) during nonneutropenia. The infections most commonly detected during neutropenia were fevers of undetermined origin (36%), clinically or microbiologically defined focal infections (33%), and bacteremias (28%). During nonneutropenia, upper respiratory tract infections (55%) were the most common. Patients needed hospitalization for infections for a total of 1951 days (i.e., a mean of 33 days per patient) and the mean number of infection episodes was 4.2 per patient. Recurrent fever developed in 21% of the children with bacteremia. Mortality caused by bacteremias was 10%. Infections during the chemotherapy of ALL were a significant cause of morbidity in children, but mortality was low.

Infections in a pediatric patient cohort with acute lymphoblastic leukemia during the entire course of treatment

“…Thus, the true incidence of otitis, gastroenteritis, eye infections, or central nervous system (CNS) infections has not been well documented [21]. The aim of the present study is to assess the type, frequency, and severity of all types of infectious complications in a pediatric patient cohort with newly diagnosed ALL.…”

“…The current cure rate of childhood ALL is more than 80% [13,18,19]. tract infection, and pneumonia are the most frequent infectious complications in febrile patients with ALL [8,21]. The widespread use of indwelling vascular catheters has altered the type of bacteremia seen overtime.…”

“…The widespread use of indwelling vascular catheters has altered the type of bacteremia seen overtime. Furthermore, prompt initiation of the appropriate empiric antibiotic treatment has improved infection outcome [8,15,21].…”

Prevalence and Safety of Intravenous Immunoglobulin Administration During Maintenance Chemotherapy in Children with Acute Lymphoblastic Leukemia in First Complete Remission: A Health Maintenance Organization Perspective

“…2,3 These infectious complications often lead to hospitalization and can be clinically significant, such as with bacteremia or fungemia. 4,5 Past studies have shown a marked immunosuppression, particularly a significant reduction in B lymphocytes, [6][7][8][9][10][11][12][13] and associated hypogammaglobulinemia, during the maintenance phase of chemotherapy for childhood ALL. Intravenous immunoglobulin (IVIG) has been used in a variety of clinical settings to reduce the frequency and severity of bacterial infections in pediatric and adult patients with primary and secondary antibody deficiencies.…”

Infections during high dose methotrexate therapy in childhood acute lymphoblastic leukemia (ALL)

“…Infections increase the risk of death and may also increase the risk of relapse due to interruption of treatment and need for a decrease in the dose of chemotherapeutic agent. 17 Nosocomial infections are important clinical complication as it can cause considerable morbidity and mortality; thus increase hospital stay and healthcare cost. Monitoring nosocomial infection rate is of great importance to establish preventing measures.…”