Background Many children with acute lymphoblastic leukaemia (ALL) experience one or more infectious complications during treatment. Infections are important to study in children with ALL because they continue to contribute to morbidity and mortality, affect quality of life for children and their families and require considerable health resources to prevent and treat.
Aims To analyse the characteristics of infective episodes (I. E.) during intensive treatment (Protocol I, M and II) in children with ALL.
Methods Objective of this study ware 55 patients with ALL who were treated according to ALL-BFM 90 and ALL-BFM 95 Protocol between January 2000 and December 2007 at the University Children’s Hospital in Skopje. We explored the characteristics of I.E., together with the causative pathogens, the episodes of febrile neutropenia (FN), the length of antibiotic treatments and the treatments with G-CSF during intensive phases of treatment (Protocol I, M and II).
Results From 55 analysed records 24 (43.64%) were male and 31 (56.36%) were female. Mean age at diagnosis was 6.0 years (1.1–15.0). Majority of the patients 43 (78%) were under 10 years and 12 (22%) were over 10 years. All of them experienced 132, 52 and 73 I. E. with 2.4, 0.9, and 1.3 infections per patient during Protocol I, M and II respectively. Regarding to the pathogens 184 (71.5%) were bacterial (102, 30 and 52 in Protocol I, M and II), 45 (17.5%) were viral (20, 14 and 11 in Protocol I, M and II) and 28 (10.8%) were fungal (10, 8, 10 in the three intensive phases respectively). There was a slight predominance of gram positive bacteria in Protocol I [Gram positive 42 (51.85%) versus gram negative 34 (41.97%)], and a very slight predominance of gram negative bacteria in Protocol II [Gram positive 16 (45.71% versus Gram negative 18 (51.42%)]. The infections were treated with antibiotic treatment in average of 23.69, 11 and 15.05 days and the number of treatments with G-CSF were in average 7.22, 2.44 and 9.20 per patient respectively in Protocol I, M and II. The number of episodes of FN in these three phases was 16.4 (29.1%), 4 (7.3%) and 22 (40%).
Summary/conclusion Evaluation of the characteristics of I. E. presented that the majority of infectious events were observed in Protocol I and also the length of antibiotic treatment was longer in this phase. But the episodes of FN together with the treatments with G-CSF were higher in Protocol II possible due to the cumulative effect of chemotherapy.
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