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

Sung, Lillian; Lange, Beverly J.; Gerbing, Robert B.; Alonzo, Todd A.; Feusner, James

doi:10.1182/blood-2007-05-091942

Cited by 188 publications

(199 citation statements)

References 12 publications

(16 reference statements)

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“…A recent study examining children with AML enrolled on a Children's Cancer Group clinical trial found that age 416 years, non-white ethnicity, and underweight status were all significantly associated with infection-related mortality (Sung et al, 2007). We did not find that malnutrition influenced TRM in our study.…”

Section: Discussioncontrasting

confidence: 51%

Incidence and predictors of treatment-related mortality in paediatric acute leukaemia in El Salvador

et al. 2009

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Survival rates among children with leukaemia in low-income countries are lower than those in high-income countries. This has been attributed in part to higher treatment-related mortality (TRM). We examined the demographics, treatment, and outcomes of paediatric patients in El Salvador with acute lymphoblastic leukaemia (ALL) or acute myeloid leukaemia (AML) to determine the incidence, causes, and risk factors for TRM. Two trained data managers collected data prospectively; no patients were excluded. Biological, socioeconomic and nutritional predictors were examined. A total of 469 patients with ALL and 78 patients with AML were included. The 2-year cumulative incidence of TRM was significantly higher among children with AML (35.4 ± 6.4%) than those with ALL (12.5±1.7%; Po0.0001). However, the proportion of deaths attributable to the toxicity of treatment did not differ significantly between AML (25/47, 53.2%) and ALL (55/107, 51.4%; P ¼ 0.98). Among children with ALL, low monthly income (P ¼ 0.04) and low parental education (P ¼ 0.02) significantly increased the risk of TRM. Among children with AML, biological, socioeconomic, and nutritional variables were not associated with TRM. In this low-income country, toxic death significantly contributes to mortality in both ALL and AML. A better understanding of the effect of socioeconomic status on TRM may suggest specific strategies for patients with ALL.

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Section: Discussioncontrasting

confidence: 51%

Incidence and predictors of treatment-related mortality in paediatric acute leukaemia in El Salvador

et al. 2009

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“…To our knowledge, no previous studies have reported such a thorough review of toxicities and associations with age and body weight at diagnosis, though many studies suggest similar associations. 12,13,18,19,26,27 We found a trend for age 10-17 years being associated with poorer survival. In contrast to previous studies, 12,13 we found a trend for being overweight being associated with improved survival in children aged 10-17 years.…”

Section: © Ferrata Storti Foundationmentioning

confidence: 64%

Effect of age and body weight on toxicity and survival in pediatric acute myeloid leukemia: results from NOPHO-AML 2004

Løhmann

Abrahamsson²,

et al. 2016

Haematologica

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T reatment for pediatric acute myeloid leukemia is very toxic and the association between outcome and age and Body Mass Index is unclear. We investigated effect of age and Body Mass Index on toxicity and survival in pediatric acute myeloid leukemia. We studied all patients who completed first induction course of NOPHO-AML 2004 (n=318). Toxicity following induction and consolidation courses (n=6) was analyzed. The probabilities of toxicity and death were determined using time-to-event analyses with Cox multivariate proportional hazard regression for comparative analyses. Age 10-17 years was associated with sepsis with hypotension [hazard ratio 2.3 (95% confidence interval 1.1-4.6)]. Being overweight (>1 standard deviation) was associated with requiring supplemental oxygen [1.9 (1.0-3.5)]. The 5-year event-free and overall survival were 47% and 71%. Children aged 10-17 years showed a trend for inferior 5-year overall survival compared to children aged 2-9 (64% vs. 76%; P=0.07). Infants showed a trend for superior 5-year event-free survival (66% vs. 43%; P=0.06). Overweight children aged 10-17 years showed a trend for superior survival [5-year event-free survival 59% vs. 40% (P=0.09) and 5-year overall survival 78% vs. 56% (P=0.06)] compared to healthy weight children aged 10-17 years. In conclusion, children aged 10-17 years and overweight children had a higher risk of grade 3-4 toxicity. Children aged 10-17 years showed inferior survival, but, unexpectedly, in this age group overweight children tended to have increased survival. This suggests different pharmacokinetics of chemotherapeutic drugs in adolescents and warrants further studies.

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“…This low TRM in CR1 HSCT patients is similar to the upfront chemotherapy infection-related mortality incidence recently published for 492 children with AML in the CCG 2961. 20 Nonetheless, with the current excellent results of chemotherapy only for pediatric AML, offering HSCT to CR1 AML children, apart from the poor-risk group, remains controversial. In our institution, we have adopted the UK-MRC recommendations and continue to offer HSCT to children with standard risk AML if there is a fully matched related donor, and continue to offer any donor HSCT for the poor-risk group.…”

Section: Discussionmentioning

confidence: 99%

A comparison of the outcomes of children with acute myelogenous leukemia in either first or second complete remission (CR1 vs CR2) following allogeneic hematopoietic stem cell transplantation at a single transplant center

Gassas

Ishaqi

Afzal

et al. 2008

Bone Marrow Transplant

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We reviewed 70 consecutive children with AML who received hematopoietic stem cell transplantation (HSCT) in our institution between 1994 and 2005. Forty-seven children were transplanted in CR1 and 23 were transplanted in CR2. BU/CY was the most common pretransplant conditioning regimen for CR1 patients and a TBI-based conditioning regimen was the most common regimen for CR2 patients. Most patients transplanted in CR1 (81%) received related donor HSCT, whereas most of the CR2 patients (74%) received unrelated donor HSCT. Expectedly, there was a significant increase in acute GVHD incidence in CR2 patients (40 vs 25% for grades I-II and 30 vs 10% for grades III-IV; P ¼ 0.02) and a significant increase in transplant-related mortality (38 vs 11%; P ¼ 0.01). Although the difference between 3-year EFS for CR1 and CR2 was not statistically significant, there was a significantly superior 3-year overall survival for CR1 patients (74 vs 51%; P ¼ 0.05). Children with relapsed AML who achieve and maintain remission until HSCT, have a reasonable survival, but the outcome of children receiving HSCT in CR1 remains superior.

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

Abstract: The primary objective was to describe the prevalence and characteristics of microbiologically defined infections and infection-related mortality (IRM)

Cited by 188 publications

References 12 publications

Incidence and predictors of treatment-related mortality in paediatric acute leukaemia in El Salvador

Incidence and predictors of treatment-related mortality in paediatric acute leukaemia in El Salvador

Effect of age and body weight on toxicity and survival in pediatric acute myeloid leukemia: results from NOPHO-AML 2004

A comparison of the outcomes of children with acute myelogenous leukemia in either first or second complete remission (CR1 vs CR2) following allogeneic hematopoietic stem cell transplantation at a single transplant center

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