Incidence of infections after therapy completion in children with acute lymphoblastic leukemia or acute myeloid leukemia: a systematic review of the literature

Abstract

Infections are a common complication of treatment for pediatric acute lymphoblastic leukemia (ALL) or acute myeloid leukemia (AML). Less is known about infections occurring after treatment. We performed a systematic review of the literature to assess the incidence of infections after therapy completion in children and young adults with ALL or AML. Twenty-eight studies, with 4138 patients, were included. Four studies reported infections in patients who did not undergo hematopoietic stem cell transplant (HSCT). Respiratory tract and urinary tract infections affected 9.9–72.5% and 2.9–19.8% of patients, respectively. Twelve studies reported infections in patients treated with HSCT. Late bacterial, viral and fungal infections affected 3.9–38.5%, 16.1–66.7%, and 0.2–41.7% of patients, respectively. Viral hepatitis affected 0.8–75.4% of patients from 12 studies. Our review suggests that infections are a frequent complication after treatment for leukemia in children, especially after HSCT and identifies several knowledge gaps in the current literature.

Keywords:

• Leukemia
• children
• survivors
• infections

Acknowledgments

We would like to thank Thomasin Adams-Webber for her assistance with the citation searches of the electronic databases. Ms. Adams-Webber is a trained librarian with expertise in conducting searches for systematic reviews in clinical research.

Potential conflict of interest

The authors report no conflict of interest. Dr. Marie-Claude Pelland-Marcotte’s fellowship at the Hospital for Sick Children (Toronto, Canada) was supported by Shire Endowment Fund for Training in Pediatric Hemostasis.