International variations in infection supportive care practices for paediatric patients with acute myeloid leukaemia

Area of Science:

• Pediatric Oncology
• Infectious Disease Management
• Hematologic Malignancies

Background:

• Infection is a major cause of morbidity and mortality in pediatric acute myeloid leukemia (AML) patients.
• Supportive care practices, particularly infection-related ones, can significantly impact patient outcomes.
• Harmonizing supportive care may improve treatment efficacy and reduce disparities.

Purpose of the Study:

• To describe and compare infection-related supportive care practices in centers belonging to two major pediatric AML cooperative groups: Children's Oncology Group (COG) and Berlin-Frankfurt-Muenster (BFM).
• To identify systematic differences in these practices between the two cooperative groups.
• To provide data that can inform efforts to harmonize supportive care and guide future research.

Main Methods:

• A survey was administered to institutions participating in the COG and BFM cooperative groups.
• The survey focused on infection-related supportive care practices, including antibacterial and antifungal prophylaxis.
• Data were collected from 216 COG and 55 BFM institutions, with an overall response rate of 83.8%.

Main Results:

• Significant differences were observed in the use of antibacterial prophylaxis: BFM institutions (32.6%) used it more frequently than COG institutions (13.3%, P < 0.0001).
• Antifungal prophylaxis was also more common in BFM institutions (91.3%) compared to COG institutions (77.0%, P = 0.03).
• Systematic variations in infection-related supportive care practices were evident between the two cooperative groups.

Conclusions:

• There are notable differences in infection-related supportive care practices between COG and BFM pediatric acute myeloid leukemia centers.
• These findings highlight the need for harmonization of supportive care protocols to ensure consistent, high-quality patient management.
• The identified differences provide a basis for future collaborative efforts and randomized trials aimed at optimizing supportive care in pediatric AML.