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Infectious Events Prior to Chemotherapy Initiation in Children with Acute Myeloid Leukemia
Authors
Joseph Beyene
Lynette Bowes
+16 more
Josee Brossard
Sonia Cellot
David Dix
Marie Chantal Ethier
Biljana Gillmeister
Donna Johnston
Victor Lewis
Bruno Michon
David Mitchell
Carol Portwine
Victoria Price
Mariana Silva
Kent Stobart
Lillian Sung
Rochelle Yanofsky
Shayna Zelcer
Publication date
26 April 2013
Publisher
Scholarship@Western
Abstract
Background:The primary objective was to describe infectious complications in children with acute myeloid leukemia from presentation to the healthcare system to initiation of chemotherapy and to describe how these infections differ depending on neutropenia.Methods:We conducted a retrospective, population-based cohort study that included children and adolescents with acute myeloid leukemia diagnosed and treated at 15 Canadian centers. We evaluated infections that occurred between presentation to the healthcare system (for symptoms that led to the diagnosis of acute myeloid leukemia) until initiation of chemotherapy.Results:Among 328 children, 92 (28.0%) were neutropenic at presentation. Eleven (3.4%) had sterile-site microbiologically documented infection and four had bacteremia (only one Gram negative). Infection rate was not influenced by neutropenia. No child died from an infectious cause prior to chemotherapy initiation.Conclusion:It may be reasonable to withhold empiric antibiotics in febrile non-neutropenic children with newly diagnosed acute myeloid leukemia until initiation of chemotherapy as long as they appear well without a clinical focus of infection. Future work could examine biomarkers or a clinical score to identify children presenting with leukemia and fever who are more likely to have an invasive infection. © 2013 Portwine et al
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oai:ir.lib.uwo.ca:paedpub-3090
Last time updated on 08/10/2022