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Infections during induction therapy of protocol CCLG-2008 in childhood acute lymphoblastic leukemia: a single-center experience with 256 cases in China.

Li SD, Chen YB, Li ZG, Wu RH, Qin MQ, Zhou X, Jiang J, Zhang RD, Xie J, Ma XL, Zhang R, Wang B, Wu Y, Zheng HY, Wu MY - Chin. Med. J. (2015)

Bottom Line: Infections remain a major cause of therapy-associated morbidity and mortality in children with acute lymphoblastic leukemia (ALL).We retrospectively analyzed the medical charts of 256 children treated for ALL under the CCLG-2008 protocol in Beijing Children's Hospital.Neutropenia was present in 83.1% of the infectious episodes.

View Article: PubMed Central - PubMed

Affiliation: Beijing Key Laboratory of Pediatric Hematology Oncology; National Key Discipline of Pediatrics, Ministry of Education; Key Laboratory of Major Diseases in Children, Ministry of Education; Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China.

ABSTRACT

Background: Infections remain a major cause of therapy-associated morbidity and mortality in children with acute lymphoblastic leukemia (ALL).

Methods: We retrospectively analyzed the medical charts of 256 children treated for ALL under the CCLG-2008 protocol in Beijing Children's Hospital.

Results: There were 65 infectious complications in 50 patients during vincristine, daunorubicin, L-asparaginase and dexamethasone induction therapy, including microbiologically documented infections (n = 12; 18.5%), clinically documented infections (n = 23; 35.3%) and fever of unknown origin (n = 30; 46.2%). Neutropenia was present in 83.1% of the infectious episodes. In all, most infections occurred around the 15 th day of induction treatment (n = 28), and no patients died of infection-associated complications.

Conclusions: The infections in this study was independent of treatment response, minimal residual diseases at the end of induction therapy, gender, immunophenotype, infection at first visit, risk stratification at diagnosis, unfavorable karyotypes at diagnosis and morphologic type. The infection rate of CCLG-2008 induction therapy is low, and the outcome of patients is favorable.

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Neutrophil count in the different time points of induction treatment (data are the mean ± SD).
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Figure 1: Neutrophil count in the different time points of induction treatment (data are the mean ± SD).

Mentions: Most infection occurred around the 15th day of induction treatment (28/65; d15 vs. d8, P < 0.01) while only four patients had infection around the 29th day (4/65; d29 vs. d22, P < 0.05). Figure 1 shows the neutrophil count at different time points of induction treatment (0.9 ± 0.1, d8; 0.8 ± 0.1, d15; 2.6 ± 0.2, d22; 1.1 ± 0.1, d29; 1.9 ± 0.1, d33). Compared to other time points of induction treatment, day 15 and day 8 showed more severe bone marrow depression.


Infections during induction therapy of protocol CCLG-2008 in childhood acute lymphoblastic leukemia: a single-center experience with 256 cases in China.

Li SD, Chen YB, Li ZG, Wu RH, Qin MQ, Zhou X, Jiang J, Zhang RD, Xie J, Ma XL, Zhang R, Wang B, Wu Y, Zheng HY, Wu MY - Chin. Med. J. (2015)

Neutrophil count in the different time points of induction treatment (data are the mean ± SD).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4836249&req=5

Figure 1: Neutrophil count in the different time points of induction treatment (data are the mean ± SD).
Mentions: Most infection occurred around the 15th day of induction treatment (28/65; d15 vs. d8, P < 0.01) while only four patients had infection around the 29th day (4/65; d29 vs. d22, P < 0.05). Figure 1 shows the neutrophil count at different time points of induction treatment (0.9 ± 0.1, d8; 0.8 ± 0.1, d15; 2.6 ± 0.2, d22; 1.1 ± 0.1, d29; 1.9 ± 0.1, d33). Compared to other time points of induction treatment, day 15 and day 8 showed more severe bone marrow depression.

Bottom Line: Infections remain a major cause of therapy-associated morbidity and mortality in children with acute lymphoblastic leukemia (ALL).We retrospectively analyzed the medical charts of 256 children treated for ALL under the CCLG-2008 protocol in Beijing Children's Hospital.Neutropenia was present in 83.1% of the infectious episodes.

View Article: PubMed Central - PubMed

Affiliation: Beijing Key Laboratory of Pediatric Hematology Oncology; National Key Discipline of Pediatrics, Ministry of Education; Key Laboratory of Major Diseases in Children, Ministry of Education; Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China.

ABSTRACT

Background: Infections remain a major cause of therapy-associated morbidity and mortality in children with acute lymphoblastic leukemia (ALL).

Methods: We retrospectively analyzed the medical charts of 256 children treated for ALL under the CCLG-2008 protocol in Beijing Children's Hospital.

Results: There were 65 infectious complications in 50 patients during vincristine, daunorubicin, L-asparaginase and dexamethasone induction therapy, including microbiologically documented infections (n = 12; 18.5%), clinically documented infections (n = 23; 35.3%) and fever of unknown origin (n = 30; 46.2%). Neutropenia was present in 83.1% of the infectious episodes. In all, most infections occurred around the 15 th day of induction treatment (n = 28), and no patients died of infection-associated complications.

Conclusions: The infections in this study was independent of treatment response, minimal residual diseases at the end of induction therapy, gender, immunophenotype, infection at first visit, risk stratification at diagnosis, unfavorable karyotypes at diagnosis and morphologic type. The infection rate of CCLG-2008 induction therapy is low, and the outcome of patients is favorable.

Show MeSH
Related in: MedlinePlus