|Title:||Infectious complications in children with acute lymphoblastic leukemia treated with the Taiwan Pediatric Oncology Group protocol: A 16-year tertiary single-institution experience||Authors:||MENG-JU LI
|Issue Date:||2017||Publisher:||John Wiley and Sons Inc.||Journal Volume:||64||Journal Issue:||10||Start page/Pages:||e26535||Source:||Pediatric Blood and Cancer||Abstract:||
Background: Infection is a major complication in pediatric patients with acute lymphoblastic leukemia during chemotherapy. In this study, the infection characteristics were determined and risk factors analyzed based on the Taiwan Pediatric Oncology Group (TPOG) acute lymphoblastic leukemia (ALL) protocol. Procedure: We retrospectively reviewed fever events during chemotherapy in 252 patients treated during two consecutive clinical trials at a single institution between 1997 and 2012. Patients were classified as standard, high, and very high risk by treatment regimen according to the TPOG definitions. We analyzed the characteristics and risk factors for infection. Results: Fever occurred in 219 patients (86.9%) with a mean of 2.74 episodes per person. The fever events comprised 64% febrile neutropenia, 39% clinically documented infections, and 44% microbiologically documented infections. The microbiologically documented infections were mostly noted during the induction phase and increased in very high risk patients (89 vs. 24% and 46% in standard-risk and high-risk patients, respectively). Younger age and higher risk (high-risk and very high risk groups) were risk factors for fever and microbiologic and bloodstream infections. Female gender and obesity were additive risk factors for urinary tract infection (odds ratios = 3.52 and 3.24, P < 0.001 and P = 0.004, respectively). Conclusions: Infections developed primarily during the induction phase, for which younger age and higher risk by treatment regimen were risk factors. Female gender and obesity were additive risk factors for urinary tract infection. ? 2017 Wiley Periodicals, Inc.
|ISSN:||1545-5009||DOI:||10.1002/pbc.26535||SDG/Keyword:||etoposide; methotrexate; prednisolone; antineoplastic agent; acute lymphoblastic leukemia; adolescent; Article; bloodstream infection; cancer chemotherapy; child; clinical trial (topic); female; fever; gender; human; infant; infection; logistic regression analysis; major clinical study; male; multivariate analysis; obesity; priority journal; retrospective study; risk factor; tertiary care center; urinary tract infection; age; chemically induced; clinical trial; febrile neutropenia; multicenter study; newborn; Precursor Cell Lymphoblastic Leukemia-Lymphoma; preschool child; sex difference; Urinary Tract Infections; Adolescent; Age Factors; Antineoplastic Combined Chemotherapy Protocols; Child; Child, Preschool; Febrile Neutropenia; Female; Humans; Infant; Infant, Newborn; Male; Obesity; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Risk Factors; Sex Factors; Urinary Tract Infections
|Appears in Collections:||醫學系|
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