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Preventive antibiotics in pediatric patients with acute myeloid leukemia (AML)

Dawn Nolt1, Susan Lindemulder2, Jeffrey Meyrowitz2

  • 1Division of Infectious Diseases, Department of Pediatrics, Doernbecher Children's Hospital, Oregon Health & Science University, Portland, Oregon.

Pediatric Blood & Cancer
|March 3, 2015
PubMed

Insights

Preventive intravenous antibiotics at the start of neutropenia in childhood acute myeloid leukemia (AML) treatment reduced infection-related deaths. This approach is safe and feasible for pediatric cancer patients.

Area of Science:

  • Pediatric Oncology
  • Infectious Diseases
  • Hematology

Background:

  • Children with acute myeloid leukemia (AML) face high infection risk during neutropenia.
  • Prophylactic antibiotics may mitigate severe infections in pediatric AML treatment.

Purpose of the Study:

  • To evaluate the impact of early intravenous (IV) antibiotic use on infection incidence and outcomes in children with AML.

Main Methods:

  • Retrospective analysis of pediatric patients (0-18 years) with de novo AML.
  • Patients treated on COG AAML0531 or UK MRC AML 10 regimens.
  • Data collected from chart reviews for 76 chemotherapy phases in 29 patients.

Main Results:

  • Preventive antibiotics were given at absolute neutrophil count <500 cells/mcl before fever.
  • Seven bacteremia episodes occurred, mainly coagulase-negative staphylococci and viridans group streptococci.
  • One infection-related death occurred due to complications from candidal pneumonia.

Conclusions:

  • Initiating preventive antibiotics at neutropenia onset showed no bacteremia-related mortality.
  • This prophylactic strategy appears feasible and safe for pediatric AML patients.
Abstract

Keywords:
AMLfeverneutropeniapreventive

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