Biljana Gillmeister

Bruno Michon

Carol Portwine

David Dix

David Mitchell

Donna L Johnston

Johann Hitzler

Josee Brossard

Joseph Beyene

Kent Stobart

Lillian Sung

Lynette Bowes

Mariana Silva

Marie-Chantal Ethier

Rochelle Yanofsky

Shayna Zelcer

Sonia Cellot

Thai Tran

Victor Lewis

Victoria Price

Infectious Agents and Cancer

Abstract
          
            Background
            Children with Down syndrome (DS) are at high risk of infectious toxicity when treated with acute lymphoblastic leukemia chemotherapy protocols optimized in children without DS. Our objective was to determine if children with DS and acute myeloid leukemia (AML) have a different risk of infection when treated with chemotherapy protocols developed for children with DS compared to AML treatment protocols developed for children without DS.
          
          
            Methods
            We conducted a retrospective, population-based cohort study that included DS children ≤ 18 years of age with de novo, non-M3 AML diagnosed between January 1995 and December 2004, and treated at 15 Canadian centers. Patients were monitored for infection from initiation of AML treatment until recovery from the last cycle of chemotherapy, conditioning for hematopoietic stem cell transplantation, relapse, persistent disease or death (whichever occurred first). Trained research associates abstracted all information from each site.
          
          
            Results
            There were 31 children with DS included; median age was 1.7 (range 0.1-11.1) years. Eleven were treated according to a DS-specific protocol while 20 were treated with non-DS specific protocols. A total of 157 courses of chemotherapy were delivered. Microbiologically documented sterile site infection occurred in 11.9% and 14.3% of DS-specific and non-DS specific AML treatment courses respectively. Sepsis was rare and there were no infection-related deaths. In multiple regression, treatment with a DS-specific protocol was independently associated with a reduction in microbiologically documented sterile site infection (adjusted odds ratio (OR) 0.65, 95% confidence interval (CI) 0.42-0.99; P = 0.044), and clinically documented infection (adjusted OR 0.36, 95% CI 0.14-0.91; P = 0.031) but not bacteremia (adjusted OR 0.73, 95% CI 0.44-1.22; P = 0.231).
          
          
            Conclusions
            Our study suggests that children with DS do not experience excessive infectious toxicity during treatment for AML compared to children without DS. Incorporation of DS-specific AML treatment protocols is associated with a more favorable infection profile for children with DS-AML.
          </jats:sec

Thai Hoa Tran

Crossref

Infections in children with down syndrome and acute myeloid leukemia: a report from the Canadian infections in AML research group

https://infectagentscancer.biomedcentral.com/track/pdf/10.1186/1750-9378-8-47?site=infectagentscancer.biomedcentral.com

Infections in children with down syndrome and acute myeloid leukemia: a report from the Canadian infections in AML research group

Abstract

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