Pneumonitis in lymphoblastic leukaemia of childhood

Abstract

In the M.R.C. UKALL VIII study, 35 of 199 (17.6%) patients on protocol developed interstitial pneumonitis within the first 44 weeks of treatment (median 10 weeks). These episodes were carefully documented, and serological investigation for Pneumocystis carinii infection was performed in 33 cases. These 35 patients were divided into two groups, one having either histological or serological evidence of P. carinii infection and the other without such evidence. We saw no false positive serological tests in the nine cases with histological confirmation, but the P. carinii immunofluorescence test was of most help in retrospectively confirming P. carinii infection. High dose trimethoprim-sulphamethoxazole was successful in treating 26 of 33 cases (78%). We did note an improvement in survival in children given steroids and we suggest they may have a role in anti-pneumonitis therapy.

Key Words:

• Acute lymphoblastic leukaemia
• pneumonitis