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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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Event free survival of patients according to the presence or absence of infections.
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Figure 3: Event free survival of patients according to the presence or absence of infections.

Mentions: The median OS and EFS of patients with infection in induction treatment were 55 and 53 months respectively, while the median OS and EFS of patients without infection during induction treatment were 55 and 54 months respectively. The OS and EFS did not show a trend of decrease (P = 0.78 and 0.67) with infection during induction chemotherapy. Examination of the survival curves demonstrated that infections during VDLD induction treatment were relatively slight, that is, infections did not influence the prognosis [Figures 2 and 3].


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)

Event free survival of patients according to the presence or absence of infections.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 3: Event free survival of patients according to the presence or absence of infections.
Mentions: The median OS and EFS of patients with infection in induction treatment were 55 and 53 months respectively, while the median OS and EFS of patients without infection during induction treatment were 55 and 54 months respectively. The OS and EFS did not show a trend of decrease (P = 0.78 and 0.67) with infection during induction chemotherapy. Examination of the survival curves demonstrated that infections during VDLD induction treatment were relatively slight, that is, infections did not influence the prognosis [Figures 2 and 3].

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