Infectious complications in children with acute lymphoblastic leukemia treated with the Taiwan Pediatric Oncology Group protocol: A 16-year tertiary single-institution experience

Meng Ju Li, Hsiu Hao Chang, Yung Li Yang, Meng Yao Lu, Pei Lan Shao, Chun Min Fu, An Kuo Chou, Yen Lin Liu, Kai Hsin Lin, Li Min Huang, Dong Tsamn Lin, Shiann Tarng Jou

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Infection is a major complication in pediatric patients with acute lymphoblastic leukemia during chemotherapy. In this study, the infection characteristics were determined and risk factors analyzed based on the Taiwan Pediatric Oncology Group (TPOG) acute lymphoblastic leukemia (ALL) protocol. Procedure: We retrospectively reviewed fever events during chemotherapy in 252 patients treated during two consecutive clinical trials at a single institution between 1997 and 2012. Patients were classified as standard, high, and very high risk by treatment regimen according to the TPOG definitions. We analyzed the characteristics and risk factors for infection. Results: Fever occurred in 219 patients (86.9%) with a mean of 2.74 episodes per person. The fever events comprised 64% febrile neutropenia, 39% clinically documented infections, and 44% microbiologically documented infections. The microbiologically documented infections were mostly noted during the induction phase and increased in very high risk patients (89 vs. 24% and 46% in standard-risk and high-risk patients, respectively). Younger age and higher risk (high-risk and very high risk groups) were risk factors for fever and microbiologic and bloodstream infections. Female gender and obesity were additive risk factors for urinary tract infection (odds ratios = 3.52 and 3.24, P < 0.001 and P = 0.004, respectively). Conclusions: Infections developed primarily during the induction phase, for which younger age and higher risk by treatment regimen were risk factors. Female gender and obesity were additive risk factors for urinary tract infection.

Original languageEnglish
JournalPediatric Blood and Cancer
DOIs
Publication statusAccepted/In press - 2017

Fingerprint

Taiwan
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Pediatrics
Infection
Fever
Urinary Tract Infections
Obesity
Drug Therapy
Febrile Neutropenia
Odds Ratio
Clinical Trials
Therapeutics

Keywords

  • Acute lymphoblastic leukemia
  • Child
  • Infection
  • Risk factors

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

Cite this

Infectious complications in children with acute lymphoblastic leukemia treated with the Taiwan Pediatric Oncology Group protocol : A 16-year tertiary single-institution experience. / Li, Meng Ju; Chang, Hsiu Hao; Yang, Yung Li; Lu, Meng Yao; Shao, Pei Lan; Fu, Chun Min; Chou, An Kuo; Liu, Yen Lin; Lin, Kai Hsin; Huang, Li Min; Lin, Dong Tsamn; Jou, Shiann Tarng.

In: Pediatric Blood and Cancer, 2017.

Research output: Contribution to journalArticle

Li, Meng Ju ; Chang, Hsiu Hao ; Yang, Yung Li ; Lu, Meng Yao ; Shao, Pei Lan ; Fu, Chun Min ; Chou, An Kuo ; Liu, Yen Lin ; Lin, Kai Hsin ; Huang, Li Min ; Lin, Dong Tsamn ; Jou, Shiann Tarng. / Infectious complications in children with acute lymphoblastic leukemia treated with the Taiwan Pediatric Oncology Group protocol : A 16-year tertiary single-institution experience. In: Pediatric Blood and Cancer. 2017.
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title = "Infectious complications in children with acute lymphoblastic leukemia treated with the Taiwan Pediatric Oncology Group protocol: A 16-year tertiary single-institution experience",
abstract = "Background: Infection is a major complication in pediatric patients with acute lymphoblastic leukemia during chemotherapy. In this study, the infection characteristics were determined and risk factors analyzed based on the Taiwan Pediatric Oncology Group (TPOG) acute lymphoblastic leukemia (ALL) protocol. Procedure: We retrospectively reviewed fever events during chemotherapy in 252 patients treated during two consecutive clinical trials at a single institution between 1997 and 2012. Patients were classified as standard, high, and very high risk by treatment regimen according to the TPOG definitions. We analyzed the characteristics and risk factors for infection. Results: Fever occurred in 219 patients (86.9{\%}) with a mean of 2.74 episodes per person. The fever events comprised 64{\%} febrile neutropenia, 39{\%} clinically documented infections, and 44{\%} microbiologically documented infections. The microbiologically documented infections were mostly noted during the induction phase and increased in very high risk patients (89 vs. 24{\%} and 46{\%} in standard-risk and high-risk patients, respectively). Younger age and higher risk (high-risk and very high risk groups) were risk factors for fever and microbiologic and bloodstream infections. Female gender and obesity were additive risk factors for urinary tract infection (odds ratios = 3.52 and 3.24, P < 0.001 and P = 0.004, respectively). Conclusions: Infections developed primarily during the induction phase, for which younger age and higher risk by treatment regimen were risk factors. Female gender and obesity were additive risk factors for urinary tract infection.",
keywords = "Acute lymphoblastic leukemia, Child, Infection, Risk factors",
author = "Li, {Meng Ju} and Chang, {Hsiu Hao} and Yang, {Yung Li} and Lu, {Meng Yao} and Shao, {Pei Lan} and Fu, {Chun Min} and Chou, {An Kuo} and Liu, {Yen Lin} and Lin, {Kai Hsin} and Huang, {Li Min} and Lin, {Dong Tsamn} and Jou, {Shiann Tarng}",
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T1 - Infectious complications in children with acute lymphoblastic leukemia treated with the Taiwan Pediatric Oncology Group protocol

T2 - A 16-year tertiary single-institution experience

AU - Li, Meng Ju

AU - Chang, Hsiu Hao

AU - Yang, Yung Li

AU - Lu, Meng Yao

AU - Shao, Pei Lan

AU - Fu, Chun Min

AU - Chou, An Kuo

AU - Liu, Yen Lin

AU - Lin, Kai Hsin

AU - Huang, Li Min

AU - Lin, Dong Tsamn

AU - Jou, Shiann Tarng

PY - 2017

Y1 - 2017

N2 - Background: Infection is a major complication in pediatric patients with acute lymphoblastic leukemia during chemotherapy. In this study, the infection characteristics were determined and risk factors analyzed based on the Taiwan Pediatric Oncology Group (TPOG) acute lymphoblastic leukemia (ALL) protocol. Procedure: We retrospectively reviewed fever events during chemotherapy in 252 patients treated during two consecutive clinical trials at a single institution between 1997 and 2012. Patients were classified as standard, high, and very high risk by treatment regimen according to the TPOG definitions. We analyzed the characteristics and risk factors for infection. Results: Fever occurred in 219 patients (86.9%) with a mean of 2.74 episodes per person. The fever events comprised 64% febrile neutropenia, 39% clinically documented infections, and 44% microbiologically documented infections. The microbiologically documented infections were mostly noted during the induction phase and increased in very high risk patients (89 vs. 24% and 46% in standard-risk and high-risk patients, respectively). Younger age and higher risk (high-risk and very high risk groups) were risk factors for fever and microbiologic and bloodstream infections. Female gender and obesity were additive risk factors for urinary tract infection (odds ratios = 3.52 and 3.24, P < 0.001 and P = 0.004, respectively). Conclusions: Infections developed primarily during the induction phase, for which younger age and higher risk by treatment regimen were risk factors. Female gender and obesity were additive risk factors for urinary tract infection.

AB - Background: Infection is a major complication in pediatric patients with acute lymphoblastic leukemia during chemotherapy. In this study, the infection characteristics were determined and risk factors analyzed based on the Taiwan Pediatric Oncology Group (TPOG) acute lymphoblastic leukemia (ALL) protocol. Procedure: We retrospectively reviewed fever events during chemotherapy in 252 patients treated during two consecutive clinical trials at a single institution between 1997 and 2012. Patients were classified as standard, high, and very high risk by treatment regimen according to the TPOG definitions. We analyzed the characteristics and risk factors for infection. Results: Fever occurred in 219 patients (86.9%) with a mean of 2.74 episodes per person. The fever events comprised 64% febrile neutropenia, 39% clinically documented infections, and 44% microbiologically documented infections. The microbiologically documented infections were mostly noted during the induction phase and increased in very high risk patients (89 vs. 24% and 46% in standard-risk and high-risk patients, respectively). Younger age and higher risk (high-risk and very high risk groups) were risk factors for fever and microbiologic and bloodstream infections. Female gender and obesity were additive risk factors for urinary tract infection (odds ratios = 3.52 and 3.24, P < 0.001 and P = 0.004, respectively). Conclusions: Infections developed primarily during the induction phase, for which younger age and higher risk by treatment regimen were risk factors. Female gender and obesity were additive risk factors for urinary tract infection.

KW - Acute lymphoblastic leukemia

KW - Child

KW - Infection

KW - Risk factors

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