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Infections in children with acute myeloid leukemia: increased mortality in relapsed/refractory patients

Olga Zając-Spychała1, Jolanta Skalska-Sadowska1, Jacek Wachowiak1

  • 1Department of Pediatric Oncology, Hematology and Transplantology, University of Medical Sciences, Poznan, Poland.

Leukemia & Lymphoma
|May 29, 2019
PubMed

Insights

Infectious complications are common in children with acute myeloid leukemia (AML). Relapsed/refractory AML patients face higher infection-related mortality and lower survival rates.

Area of Science:

  • Pediatric Oncology
  • Infectious Diseases
  • Hematology

Background:

  • Acute myeloid leukemia (AML) is a complex hematologic malignancy.
  • Infectious complications significantly impact patient outcomes in AML.
  • Understanding infection epidemiology is crucial for managing AML patients.

Purpose of the Study:

  • To describe the epidemiology and profile of bacterial, fungal, and viral infections in pediatric AML.
  • To compare infection characteristics between de novo and relapsed/refractory AML.
  • To assess the impact of infections on mortality and survival in AML.

Main Methods:

  • Nationwide study involving children with primary and relapsed/refractory AML.
  • Retrospective analysis of diagnosed infectious complications: bacterial infections (BI), invasive fungal disease (IFD), and viral infections (VI).
  • Comparison of infection rates, types, and outcomes between different AML patient groups.

Main Results:

  • 76% of primary AML patients and 67.2% of relapsed/refractory AML patients experienced infectious complications.
  • Bacterial infections were predominant, with Gram-negative strains often multi-drug resistant.
  • Relapsed/refractory AML patients had significantly higher infection-related mortality and lower survival from infection.

Conclusions:

  • Infectious complications are highly prevalent in pediatric AML, particularly bacterial infections.
  • While IFD and VI characteristics are similar, relapsed/refractory AML poses a greater mortality risk due to infections.
  • Targeted infection management strategies are vital for improving outcomes in pediatric AML, especially in relapsed/refractory cases.
Keywords:
Acute myeloid leukemiainfectionrefractorinessrelapse

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