Infections Occurring During the Courses of Anticancer Chemotherapy in Children with All: A Retrospective Analysis of 59 Patients

Abstract

In a retrospective analysis we evaluated the occurrence of infections in 59 children with acute lymphoblastic leukemia (ALL) during the entire duration of their anticancer chemotherapy. We recorded a total of 245 infection episodes, 118 (50%) being during neutropenia and 119 (50%) during nonneutropenia. The infections most commonly detected during neutropenia were fevers of undetermined origin (36%), clinically or microbiologically defined focal infections (33%), and bacteremias (28%). During nonneutropenia, upper respiratory tract infections (55%) were the most common. Patients needed hospitalization for infections for a total of 1951 days (i.e., a mean of 33 days per patient) and the mean number of infection episodes was 4.2 per patient. Recurrent fever developed in 21% of the children with bacteremia. Mortality caused by bacteremias was 10%. Infections during the chemotherapy of ALL were a significant cause of morbidity in children, but mortality was low.

Key Words:

• acute lymphoblastic leukemia
• bacteremia
• chemotherapy
• children
• febrile neutropenia

Additional information

Notes on contributors

J. Rahiala

Joyce Laing works in the Department of Child and Family Psychiatry, Playfield House, Cupar, Fife, and is a Consultant Art Therapist to Psychiatric Hospitals and Prisons and Chairwoman of the Scottish Society of Art and Psychology.

Dr Niculescu Dan, Centrul de Reumatologie, Str. J. (F)ucick no. 5, Bucuresti, Romania

Anni Vilppula, Department of Medicine, Paimio Hospital, Preitilä, Finland

G. Tausch, Department of Rheumatology, Municipal Hospital of Vienna-Lainz, Wolkersbergenstraße 1, A-1130Wien, Austria

Dr Guido Gothoni, Medica Pharmaceutical Company Ltd., P.O. Box 325, SF-00101 Helsinki 10, Finland

A. Elman, Dept. of Rheumatology, Karolinska sjukhuset, Stockholm, Sweden

Hannu Paitälä, Rheumatism Foundation Hospital, Heinola, Finland

Jonas Jonsson, National Bacteriological Laboratory, S-105 21 Stockholm, Sweden