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[Septicemia in children with malignant disease]
Y Hatae1, T Takeda, H Nakadate
1Dept. of Pediatrics, National Sapporo Hospital, Hokkaido Cancer Center.
Gan to Kagaku Ryoho. Cancer & Chemotherapy
|October 1, 1990
Summary
Childhood cancer patients with neutropenia (low neutrophil count) face a high risk of septicemia (blood infection). Lower granulocyte counts significantly increase the likelihood of infection and death in these vulnerable children.
Area of Science:
- Pediatric Oncology
- Infectious Diseases
- Hematology
Background:
- Severe infections are a leading cause of death in pediatric cancer patients.
- Septicemia poses a significant threat, contributing to morbidity and mortality in this population.
- Understanding risk factors is crucial for improving outcomes.
Purpose of the Study:
- To analyze the incidence, causative organisms, and mortality of septicemia in children with malignancy.
- To identify key risk factors, particularly neutrophil counts, associated with septicemia development and outcomes.
- To evaluate differences in septicemia occurrence between hematologic and solid tumors.
Main Methods:
- Retrospective analysis of 1,468 childhood cancer patients treated between 1979 and 1988.
- Data collection on septicemia episodes, including causative pathogens and patient characteristics.
- Correlation of absolute neutrophil count (ANC) with septicemia incidence and mortality.
Main Results:
- 34 septicemia episodes occurred; higher incidence and mortality in hematologic malignancies versus solid tumors.
- Klebsiella pneumoniae and Staphylococcus epidermidis were the most common pathogens; Gram-negative bacteria predominated.
- Neutropenia, especially ANC < 500/µL and granulocyte count < 100/µL, was strongly associated with septicemia and death.
Conclusions:
- Neutropenia is a critical risk factor for septicemia in pediatric malignancy.
- Close monitoring and management of neutropenic children with cancer are essential to reduce septicemia-related mortality.
- Early detection and appropriate antimicrobial therapy are vital for improving survival rates.