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Infections in acute lymphoblastic leukaemia
1Department of Paediatric Medicine, KK Women's and Children's Hospital, Singapore.
Annals of the Academy of Medicine, Singapore
|October 29, 1998
Summary
Febrile neutropenia in acute lymphoblastic leukaemia (ALL) patients often results from infections, primarily Gram-negative bacteria. Factors like prolonged neutropenia and leukaemia relapse significantly increase mortality risk.
Area of Science:
- Pediatric Oncology
- Infectious Diseases
- Hematology
Background:
- Febrile neutropenia is a common complication in children undergoing treatment for acute lymphoblastic leukaemia (ALL).
- Understanding infection types and mortality factors is crucial for improving patient outcomes.
Purpose of the Study:
- To identify the types of infections and etiological agents causing febrile neutropenia in pediatric ALL patients.
- To determine factors influencing mortality in these patients.
Main Methods:
- Retrospective analysis of 77 episodes of febrile neutropenia in 32 children treated under the UK ALL protocol (1986-1995).
- Documentation of infection types, causative agents, and mortality-associated factors.
Main Results:
- Infections accounted for 61% of febrile neutropenia episodes; unknown causes were 39%.
- Gram-negative bacteraemia was the most common documented infection.
- Overall mortality was 22% (7 deaths), with 9% due to sepsis and 4 deaths linked to leukaemia relapse.
- Prolonged neutropenia, leukaemia relapse, and invasive fungal infections increased mortality.
Conclusions:
- Infections, particularly Gram-negative bacteraemia, are significant contributors to febrile neutropenia in pediatric ALL.
- Leukaemia relapse, prolonged neutropenia, and fungal infections are key factors associated with increased mortality.