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Infectious profile in children with ALL during chemotherapy: A report of study group for infections
Joanna Zawitkowska1, Katarzyna Drabko1, Anna Szmydki-Baran2
1Department of Pediatric Hematology, Oncology and Transplantation, Medical University, Lublin, Poland.
Insights
Infections are common in pediatric acute lymphoblastic leukemia (ALL) patients, with bacterial infections most frequent. Fungal infections contributed significantly to the 2.4% treatment-related mortality observed in this study.
Area of Science:
- Pediatric Hematology
- Infectious Diseases
- Oncology
Background:
- Treatment-related mortality in pediatric acute lymphoblastic leukemia (ALL) is primarily driven by infections.
- Understanding infection patterns is crucial for improving outcomes in children with ALL.
Purpose of the Study:
- To analyze the incidence, epidemiology, infection profiles, and mortality rates in children with ALL in Poland.
- To provide insights into infectious disease patterns in a specific pediatric ALL patient population.
Main Methods:
- Retrospective analysis of 1363 pediatric patients (aged 1-18) diagnosed with ALL between 2012-2017.
- Patients were treated according to ALL IC-BFM 2002 and 2009 protocols across 17 Polish centers.
- Infection data included microbiological documentation, PCR for viral infections, and diagnostic criteria for fungal infections.
Main Results:
- Bacterial infections were most common, affecting 53.2% of patients (1511 episodes).
- Viral infections occurred in 18.4% of patients (304 episodes via PCR).
- Fungal infections were reported in 20.4% of patients, with a notable increase in recent years; fungal infections were the primary cause of the 2.4% mortality rate.
Conclusions:
- Bacterial infections are the most frequent in Polish pediatric ALL patients, followed by fungal and viral infections.
- The observed mortality rate of 2.4% aligns with previous studies.
- Fungal infections represent a significant cause of mortality in this population, warranting attention.
Introduction:
The treatment-related mortality in currently published studies of acute lymphoblastic leukemia (ALL) in children is 2-4%, mainly due to infections. The aim of the study was to analyse the incidence, epidemiology, profile of infection and the death rate in children with ALL.
Patients And Methods:
The retrospective analysis included 1363 patients, aged 1-18 years, with newly diagnosed ALL, who were treated in 17 pediatric hematology centers between 2012 and 2017 in Poland. The patients received therapy according to the ALL IC-BFM 2002 and 2009 (International Berlin-Frankfurt-Munster Study Group) protocols.
Results:
In our study, 726 out of 1363 (53.2%) children were reported to have a microbiologically documented bacterial infection during chemotherapy. 1511 episodes of these infection were diagnosed. A total number of 251/1363 (18.4%) children experienced a viral infection. 304 episodes were documented by PCR test (polymerase chain reaction). A fungal infection was reported in 278 (20.4%) children, including 10.1% of probable, 6.0% of proven, 83% of possible diagnosis. A higher frequency of fungal infection was noted in the recent years. In our material, the rate of death was 2.4%, mainly due to fungal infection.
Conclusions:
Our results present the epidemiology of infectious disease in the Polish ALL patient population. The most frequent were bacterial infections, followed by fungal and viral ones. Similar to the previously published data, the mortality rate in our material was 2.4%.
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