Infectious complications in children with acute myeloid leukemia: decreased mortality in multicenter trial AML-BFM 2004

Infections are an important cause for morbidity and mortality in pediatric acute myeloid leukemia (AML). We therefore characterized infectious complications in children treated according to the trial AML-BFM 2004. Patien
Infections are an important cause for morbidity and mortality in pediatric acute myeloid leukemia (AML). We therefore characterized infectious complications in children treated according to the trial AML-BFM 2004. Patients with Down syndrome were excluded from the analysis. Data were gathered from the medical records in the hospital where the patients were treated. A total of 405 patients (203 girls; median age 8.4 years) experienced 1326 infections. Fever without identifiable source occurred in 56.1% of the patients and clinically and microbiologically documented infections in 17.5% and 32.4% of the patients, respectively. In all, 240 Gram-positive (112 viridans group streptococci) and 90 Gram-negative isolates were recovered from the bloodstream. Invasive fungal infection was diagnosed in 3% of the patients. Three children each died of Gram-negative bacteremia and invasive aspergillosis, respectively. As compared with the results of AML-BFM 93 with lower dose intensity, infection-related morbidity was slightly higher in AML-BFM 2004 (3.3. versus 2.8 infections per patient), whereas infection-related mortality significantly decreased (1.5% versus 5.4%; P=0.003). Specific anti-infective recommendations included in the treatment protocol, regular training courses for pediatric hematologists and increasing experience may be the reason for reduced infection-related mortality in children with AML. Further studies are needed to decrease infection-related morbidity.
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Author:Konrad Bochennek, Angela Hassler, Corinna Perner, Julia Gilfert, Stefan Schöning, Thomas Klingebiel, Dirk Reinhardt, Ursula Creutzig, Thomas Lehrnbecher
URN:urn:nbn:de:hebis:30:3-417187
DOI:http://dx.doi.org/10.1038/bcj.2015.110
ISSN:2044-5385
Pubmed Id:http://www.ncbi.nlm.nih.gov/pubmed?term=26771808
Parent Title (English):Blood cancer journal
Publisher:Nature Publishing Group
Place of publication:London [u.a.]
Document Type:Article
Language:English
Year of Completion:2016
Date of first Publication:2016/01/15
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2016/10/21
Volume:6
Issue:e382
Pagenumber:6
Note:
This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
HeBIS PPN:42481854X
Institutes:Medizin
Dewey Decimal Classification:610 Medizin und Gesundheit
Sammlungen:Universitätspublikationen
Licence (German):License LogoCreative Commons - Namensnennung 4.0

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