In a nutshell
This study examined the risk of infection in childhood acute lymphoblastic leukemia patients. This study concluded that certain factors were associated with an increased risk of infection. These included age, race, and higher risk leukemia.
Improvements in treatment options for acute lymphoblastic leukemia (ALL) has led to long-term survival in many patients. Treatments for ALL, however, can be associated with many side effects, such as increased risk of infection. It is important to understand the risk factors associated with infection.
Studies have examined side effects associated with induction treatment. This refers to treatment to induce remission (no sign of active disease). The risk of infection throughout the entire treatment period is still under investigation.
Methods & findings
The current study explored infection-related complications and the associated risk factors in ALL patients. The records of 409 children from a 10-year period were examined.
There were 2,420 reported infections. Febrile neutropenia (fever associated with low white blood cell levels) occurred in 1,107. The remaining 1,313 were documented infections. The most common were upper respiratory tract infections (389 patients). Others included ear infections, blood infections, and gastrointestinal infections. The rate of death due to infection was 0.98%.
Younger age (under age 10) was associated with a higher risk of febrile neutropenia throughout treatment. It was associated with increased infection risk in the continuation phase of treatment. Standard and higher-risk patients underwent more intensive treatment during the continuation phase. They were more likely to experience febrile neutropenia and infection. Those of the white race were also at higher risk of infection during induction treatment.
Dexamethasone (Ozurdex; a steroid) was a treatment used during continuation. Patients who did not see an increase in white blood cells with this treatment were at a higher risk of infection.
The bottom line
This study concluded that certain factors increased the risk of developing infections in ALL. These included younger age, white race, being female, and having standard or higher-risk disease. The authors suggest these patients should be monitored for infection and treated early.
Published By :
Annals of oncology : official journal of the European Society for Medical Oncology
Feb 01, 2017