Related Experiment Videos
Infections in leukemic children: a prospective analysis
Abstract:
A 28-month prospective study of 54 leukemic children was carried out to determine the incidence and type of infection associated with febrile episodes. Fever was caused by infections in 84 of 199 episodes (71%). Two-thirds of the febrile episodes and 57% of the documented infections occurred when leukemic activity was demonstrable. However, only nine of 29 febrile episodes which occurred at the time of initial diagnosis of acute leukemia were due to infection. All serious bacterial infections occurred in children with absolute granulocyte counts less than 500/mm3. Septicemia was responsible for seven of the 17 deaths which occurred during the period of observation. The five children with Pseudomonas infections were colonized 10 to 30 days before they developed their infection. The majority of viral infections occurred in patients in remission, and were principally caused by cytomegalovirus, varicella-zoster virus, or Epstein-Barr virus. With the exception of one patient who died with a complex infection (CMV and Pneumocystis carinii), the children in this study responded well to viral infections.
Insights
Infections frequently cause fever in leukemic children, especially during active disease. Bacterial infections are serious, particularly with low granulocyte counts, while viral infections are common during remission.
Area of Science:
- Pediatric Oncology
- Infectious Diseases
- Hematology
Background:
- Febrile episodes are common in children with leukemia.
- Understanding infection types and incidence is crucial for managing febrile episodes in pediatric leukemia patients.
Purpose of the Study:
- To determine the incidence and types of infections associated with febrile episodes in leukemic children.
- To analyze the relationship between leukemic activity and infection occurrence.
- To identify risk factors for serious infections and mortality.
Main Methods:
- A prospective study conducted over 28 months.
- Involved 54 children diagnosed with leukemia.
- Monitored febrile episodes and documented infections.
Main Results:
- Infections caused 71% of 199 febrile episodes.
- Two-thirds of febrile episodes and 57% of infections occurred during active leukemia.
- Serious bacterial infections were linked to absolute granulocyte counts < 500/mm3; septicemia caused 7 of 17 deaths.
- Pseudomonas infections followed colonization; viral infections (CMV, VZV, EBV) were more common during remission.
Conclusions:
- Infections are a major cause of fever in pediatric leukemia.
- Leukemic activity influences infection risk.
- Close monitoring and management of infections, particularly bacterial ones, are critical for improving outcomes in leukemic children.