Infectious Complications During Reinduction in Children with Relapsed Acute Lymphoblastic Leukemia: A Descriptive...

Area of Science:

• Pediatric Oncology
• Infectious Diseases
• Hematology

Background:

• Relapsed acute lymphoblastic leukemia (ALL) in children presents significant challenges, including increased infection risk and treatment-related mortality.
• Intensive chemotherapy reinduction is standard for relapsed ALL, but serious infections can impede curative treatment.

Purpose of the Study:

• To determine the incidence and patterns of infections during chemotherapy reinduction in pediatric patients with relapsed ALL.
• To identify factors associated with infection and their impact on hospitalization and survival.

Main Methods:

• Retrospective chart review of 43 pediatric patients with relapsed ALL treated with combination chemotherapy reinduction.
• Data collected on patient demographics, treatment, neutropenia duration, infection occurrence, hospitalization length, and overall survival.

Main Results:

• 51% of patients experienced at least one infection; 16% had fungal infections.
• Infections were associated with significantly longer hospitalizations (median 17 vs. 7 days).
• Hyperglycemia and prolonged neutropenia (≥21 days) showed trends towards increased infection risk, though not statistically significant. Overall survival was not affected by infection status.

Conclusions:

• Infectious complications are frequent during ALL reinduction chemotherapy, necessitating improved supportive care.
• Development of safer, targeted reinduction strategies is crucial to optimize outcomes for children with relapsed ALL.