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Incidence of Infectious Complications in Children With Acute Lymphoblastic Leukemia Treated With Hematopoietic Stem
A Zaucha-Prażmo1, J R Kowalczyk1, K Drabko1
1Department of Pediatric Hematology, Oncology and Transplantology, Medical University, Lublin, University Children Hospital, Lublin, Poland.
Insights
Infections are common in children with acute lymphoblastic leukemia (ALL) undergoing hematopoietic stem cell transplantation (HSCT). Viral infections were more frequent in matched unrelated donor transplants, and all infections occurred more often in patients transplanted in first complete remission.
Area of Science:
- Pediatric Hematology
- Infectious Diseases
- Transplantation Immunology
Background:
- Hematopoietic stem cell transplantation (HSCT) is a crucial treatment for pediatric acute lymphoblastic leukemia (ALL).
- Infectious complications significantly impact patient outcomes following HSCT.
- Understanding infection patterns is vital for optimizing care in this vulnerable population.
Purpose of the Study:
- To investigate the incidence and types of infections in children with ALL treated with allogeneic HSCT.
- To analyze the profile of bacterial, viral, and fungal infections.
- To identify factors associated with infection occurrence, including donor type and disease status.
Main Methods:
- Retrospective analysis of hospital records from 67 pediatric patients with ALL who underwent allogeneic HSCT.
- Microbiologically documented infections were categorized as bacterial (BI), viral (VI), and fungal (FI).
- Comparison of infection rates based on donor type (matched unrelated donor vs. sibling/mismatched related donors) and disease status (CR1 vs. ≥CR2).
Main Results:
- A high incidence of infections was observed: 84 BI (31 patients), 93 VI (50 patients), and 27 FI (22 patients).
- Viral infections were significantly more frequent in recipients of matched unrelated donor (MUD) HSCT compared to matched sibling donor (MSD) or mismatched related donor (MMFD) transplants (P = .001).
- All infection types (BI, VI, FI) were more frequent in patients transplanted in first complete remission (CR1) versus those in ≥CR2 (P < .05).
Conclusions:
- Infectious complications represent a significant cause of morbidity in pediatric ALL patients undergoing allogeneic HSCT.
- The overall incidence of infections is high in this patient group.
- Disease status at transplantation (CR1) and MUD HSCT are associated with increased infectious risks, highlighting areas for targeted prevention strategies.
Objective:
We analyzed incidence and profile of infections in children with acute lymphoblastic leukemia (ALL) treated with hematopoietic stem cell transplantation (HSCT) in Polish pediatric HSCT departments, over a 2-year period.
Patients And Methods:
Hospital records of 67 patients, who underwent allogeneic HSCT for ALL, were analyzed retrospectively for microbiologically documented infection: bacterial infection (BI), viral infection (VI), and fungal infection (FI). The majority of patients (40/67; 59.7%) underwent HSCT from matched unrelated donors (MUD).
Results:
In total, 84 BI in 31 patients, 93 VI in 50 patients, and 27 FI in 22 patients were diagnosed. No differences were found in the frequency of occurrence of BI according to the type of transplant (P = .16); the occurrence of VI was statistically more frequent in MUD transplant recipients as compared with matched sibling donors (MSD) and mismatched related donors (MMFD; P = .001) and there was a trend in MUD patients for the higher occurrence of FI in comparison with MSD and MMFD transplants (P = .08). Regarding disease status, the occurrence of BI, VI, and FI was statistically more frequent in children who underwent transplantation in their first complete remission (CR1), rather than those who underwent transplantation in ≥CR2 (P < .05). In conclusion, infectious complications are an important cause of morbidity in children with ALL treated with allogeneic HSCT and the incidence of infections is high in this group of patients.
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