Infections in pediatric acute promyelocytic leukemia: From the canadian infections in acute myeloid leukemia research group

Authors

Sonia Cellot, CHU Sainte-Justine - Le Centre Hospitalier Universitaire Mère-Enfant
Donna Johnston, Children's Hospital of Eastern Ontario, Ottawa
David Dix, BC​ Children​'​​s Hospital
Marie Chantal Ethier, Hospital for Sick Children University of Toronto
Biljana Gillmeister, Hospital for Sick Children University of Toronto
David Mitchell, Centre Universitaire de Santé McGill, Hôpital de Montreal Pour Enfants
Rochelle Yanofsky, CancerCare Manitoba
Victor Lewis, Alberta Children's Hospital
Carol Portwine, McMaster Children's Hospital
Victoria Price, IWK Health Centre
Shayna Zelcer, London Ontario Health Sciences CentreFollow
Mariana Silva, Cancer Centre of Southeastern Ontario
Lynette Bowes, New Janeway Children’s Health and Rehabilitation Centre
Bruno Michon, CHU de Québec - Université Laval
Kent Stobart, University of Alberta Hospital
Josee Brossard, Centre Hospitalier Universitaire de Sherbrooke
Joseph Beyene, Hospital for Sick Children University of Toronto
Lillian Sung, Hospital for Sick Children University of Toronto

Document Type

Article

Publication Date

6-4-2013

Journal

BMC Cancer

Volume

13

URL with Digital Object Identifier

10.1186/1471-2407-13-276

Abstract

Background: It is not known whether children with acute promyelocytic leukemia (APL) have an infection risk similar to non- APL acute myeloid leukemia. The objective was to describe infectious risk in children with newly diagnosed APL and to describe factors associated with these infections.Methods: We conducted a retrospective, population-based cohort study that included children ≤ 18 years of age with de novo APL treated at 15 Canadian centers. Thirty-three children with APL were included; 78.8% were treated with APL -specific protocols.Results: Bacterial sterile site infection occurred in 12 (36.4%) and fungal sterile site infection occurred in 2 (6.1%) children. Of the 127 chemotherapy courses, 101 (79.5%) were classified as intensive and among these, the proportion in which a sterile site microbiologically documented infection occurred was 14/101 (13.9%). There was one infection-related death.Conclusions: One third of children with APL experienced at least one sterile site bacterial infection throughout treatment and 14% of intensive chemotherapy courses were associated with a microbiologically documented sterile site infection. Infection rates in pediatric APL may be lower compared to non- APL acute myeloid leukemia although these children may still benefit from aggressive supportive care during intensive chemotherapy. © 2013 Cellot et al.; licensee BioMed Central Ltd.