Infections in pediatric acute promyelocytic leukemia: from the canadian infections in acute myeloid leukemia research group

BMC Cancer

Lillian Sung⁸  Joseph Beyene⁸  Josee Brossard^1,13  Kent Stobart^1,14  Bruno Michon⁴  Lynette Bowes¹  Mariana Silva^1,15  Shayna Zelcer⁵  Victoria Price^1,11  Carol Portwine^1,10  Victor Lewis⁶  Rochelle Yanofsky⁷  David Mitchell^1,12  Biljana Gillmeister⁸  Marie-Chantal Ethier⁸  David Dix²  Donna Johnston⁹  Sonia Cellot³ 

[1]Hematology/Oncology, Janeway Child Health Center, 300 Prince Philip Drive, St. John’s, NF, A1B 3V6, Canada

[2]Pediatric Hematology/Oncology, British Columbia Children’s Hospital, 4480 Oak Street, Vancouver, BC, V6H 3N1, Canada

[3]Hematology/Oncology, Hospital Sainte-Justine, 3475 Chemin Cote Ste-Catherine, Montreal, QC, H3T 1C5, Canada

[4]Pediatric Hematology/Oncology Centre, Hospitalier Universitaire de Quebec, 2705 Boulevard Laurier, Quebec, QC, G1V 4G2, Canada

[5]Hematology/Oncology, London Health Sciences, 800 Commissioner’s Road East, London, ON, N6C 2V5, Canada

[6]Hematology/Oncology/Transplant Program, Alberta Children’s Hospital, 2888 Shaganappi Trail NW, Calgary, AB, T3B 6A8, Canada

[7]Hematology/Oncology, CancerCare Manitoba, 675 McDermot Avenue, Winnipeg, MB, R3E 0V9, Canada

[8]Child Health Evaluative Sciences, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada

[9]Hematology Oncology, Children’s Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada

[10]Hematology/Oncology, McMaster Children’s Hospital at Hamilton Health Sciences, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada

[11]Pediatrics, IWK Health Centre, 5850/5980 University Avenue, P.O. Box 9700, Halifax, NS, B3K 6R8, Canada

[12]Hematology/Oncology, Montreal Children’s Hospital, 2300 rue Tupper, Montreal, QC, H3H 1P3, Canada

[13]Hematology/Oncology, Centre Hospitalier Universitaire de Sherbrooke, 3001 12e Avenue Nord, Sherbrooke, QC, J1H 5N4, Canada

[14]Stollery Children’s Hospital, University of Alberta Hospital, 11405 87 Ave, Edmonton, AB, T6G 1C9, Canada

[15]Hematology/Oncology, Cancer Centre of Southeastern Ontario at Kingston, 25 King St, W Kingston, ON, K7L 5P9, Canada

关键词: Acute myeloid leukemia;    Sepsis;    Bacteremia;    Acute promyelocytic leukemia;    Infection;   

Others  :  1079715
DOI  :  10.1186/1471-2407-13-276

 received in 2012-12-18, accepted in 2013-05-29,  发布年份 2013

【 摘 要 】

Background

It is not known whether children with acute promyelocytic leukemia (APL) have an infection risk similar to non- APL acute myeloid leukemia. The objective was to describe infectious risk in children with newly diagnosed APL and to describe factors associated with these infections.

Methods

We conducted a retrospective, population-based cohort study that included children ≤ 18 years of age with de novo APL treated at 15 Canadian centers. Thirty-three children with APL were included; 78.8% were treated with APL -specific protocols.

Results

Bacterial sterile site infection occurred in 12 (36.4%) and fungal sterile site infection occurred in 2 (6.1%) children. Of the 127 chemotherapy courses, 101 (79.5%) were classified as intensive and among these, the proportion in which a sterile site microbiologically documented infection occurred was 14/101 (13.9%). There was one infection-related death.

Conclusions

One third of children with APL experienced at least one sterile site bacterial infection throughout treatment and 14% of intensive chemotherapy courses were associated with a microbiologically documented sterile site infection. Infection rates in pediatric APL may be lower compared to non- APL acute myeloid leukemia although these children may still benefit from aggressive supportive care during intensive chemotherapy.

【 授权许可】

   
2013 Cellot et al.; licensee BioMed Central Ltd.

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