Fever in children with acute lymphoblastic leukemia

In this study among children with acute lymphoblastic leukemia, more febrile episodes occurred during induction of remission and relapse than during remission. Infection was mainly responsible for fever during remission, regardless of the neutrophil count. However, during induction and relapse, evidence suggests that the underlying malignancy is the more likely cause of fever if the neutrophil count exceeds 200 per mm3. For all cases, the risk of serious infection was high with severe neutropenia (neutrophil count less than 200 per mm3). Of the organisms identified, gram-positive and gram-negative bacteria were equally represented. Infection remains a serious problem in the management of children with leukemia.