Pattern of infectious diseases in acute leukemia during induction therapy
Keywords:
infectious disease, leukemia, induction therapy
Abstract
An prospective study was conducted to determine risk factors and pattem of infectious diseases in acute leukemia during induction therapy. The study subjects were all new acute leukemia patients of J month to 17 years old diagnosed between August 1, 1997 and July 31, 1998 in the Department of Child Heallb, Cipto Mangunkusumo Hospital, Jakarta. Subjects were categorized into Group with and without infection. Of the 39 subjects studied (23 boys and 16 girls), 22 subjects were infected (10 boys and 12 girl ). Most of the subjects were 1-4 year-old age group and 14 subjects of that group were infected. lt was found that there were relationships between incidence of infection with leukocyte count below 5000/µL (p=0.02), neutrophil count below 1x109/L (p=0.01), and evidence of presumptive site of infection (p=0.0005). Children under 5 years old, sex, ANLL type, malnutrition, or neutropenia of more than 2 weeks had no relationships with incidence of infection. Besides fever, pattem of infection diseases in acute leukemia patients during induction therapy, were only 36% and 38% of subjects had clinical manifestations evidence andmicrobiologically documented, respectively. Most of the laboratory findings were leukopenia or neutropenia, while serum aminotransferase was normal in both groups. Serum CRP serum was devated in those with infection. All of the isolated bacteriae were Gram-negative; 52.4% of infected subjects had responded to empirical therapy, and 72.7% of the antibiotics used was sefotaxime.
References
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2. Crist WM, Pui CH. The leukemias. In: Behrman RE, Kliegman RM, Arvin AM, eds. Nelson Textbook of pediatrics. 15th ed. Philadelphia: WB Saunders Company 1996; 1452-7.
3. Abdulsalam M, Zacharia J , Setianingsih I, et al. Kasus leukemia limfoblastik akut pada anak dengan masa hidup 5 tahun. Presented at Konggres Nasional Ilmu Kesehatan Anak (KONIKA) ke X di Semarang, pada tanggal 13-17 Juni 1993.
4. Walter H. Infection in the compromised host. In: Behrman RE, Kliegrnan RM, Arvin AM, eds. Nelson Textbook of pediatrics. 15th ed. Philadelphia: WB Saunders Company;1996.p. 733-44.
5. Schimpff SC. Infections in the compromised host-an overview. In: Mandell GL, Douglas RG, Bennett JE, eds. Principles and practice of infectious diseases. 3rd ed. New York Churchill Livingstone 1990; 2258-65.
6. Ho WG, Winston OJ. Infection and transfusion therapy in acute leukaemia. In Gale RP Hoffbrand AV, eds. Clmtcs m haematology. London: WB Saunders Com. 1986, 15:873-904.
7. Cherry D, Feigin RD.lnfection in the compromi cd host. In: Stiehm ER, Fulginiti VA eds. Immunologic disorders in infants and children. 2nd ed. Philadelphia: WB Saunders Company 1980; 715-44.
8. Freifield AG, Hathorn JW, Pizzo PA. lnfectious complication in the pediaatric cancer patient. In: Pizzo PA, Poplack DG, eds. Principles and practice of pediatric oncology. 2nd ed Philadelphia: JB Lippincott Company 1990; 1009-11.
9. Schimpff SC. Infection in the leukemia patient: Diagnosis, therapy, and prevention. In: Whittaker JA, 0 lamose IW, eds. Leukemia. Oxford: Blackwell Scientific Publications 1987; 687-709.
10. Giamarellou H. Empiric therapy for infections in the febrile, neutropenic, compromised host Med Clin North Am 1995; 79:559-80.
11. Sinniah D, Close P, Lange B. Management of infection. In: DEAngio GJ, Sinniah D, Meadow AT, et al, ed. Practical pediatric oncology. New York: Wiley-Liss 1992; 83-93.
12. Bodey GP. Overview of the problem of infectious in the immunocompromised host. Am J Med 1985; 79:56-61.
13. Phair JP. Syndromes of host immunoincompetence. In: Shulman ST, Phair JP, Sonuners RM, eds. The biologic & clinical basis of infectious diseases. 4th ed. Philadelphia: WB Saunders Company 1992· 372-9.
14. Klastersky J. Febrile neutropenia: Current status and future directions. Anti-bacterial chronicle 1995; 1-5.
15. Murphy R. Infection in the compromised host. In: Shulman ST, Phair JP, Sonuners HM, eds. The biologic & clinical basis of infectious diseases. 4th ed. Philadelphia: WB Saunders Company 1992· 394-405.
16. Hughes WT, 1'uienkeji H, Bartley DL. The immune compromised host. Pediatr Clin North Am 1983; 30:103-20.
17. Meunier F. Infections in patients with acute leukemia and lymphoma. In: Mandell GL, Dougla RG, Bennett JE, penyunting. Principles and practice of infectious diseases. 3rd ed. New York: Churchill Livingstone 1990; 2265-75.
18. Meadows AT, Belasco JB, Sinniah D. Acute lymphoblastic leukemia. In: DEAngio GJ, Sinniah D, Meadows AT, et al, eds. Practical pediatric oncology. New York: Willey-Liss 1 2; 235-44.
19. Sallan SE, Billet A. Acute leukemia in childhood. In: Brain MC, Carbone PP, eds. Current therapy in hematology. 4th ed. Philadelphia: BC Decker 1992; 68-73.
20. Abdulsalam M, Markum AH, Wahidiyal I, et al. Some epidemiological aspects of childhood leukemia in Jakarta. Presented at 2nd Asian Congress of Pediatrics, Jakarta, 3-6 Agustus 1976.
21. Advani SH, Kochupillai V Shanta Y, et al. Infections in the immunocompromised host: a prospective multicenter survey in patients receiving chemotherapy for acute leukemia. JAP1. 1996; 40:769-73.
22. Bodey GP Buckley M, Sathe YS, Freireicb EJ. Quantitative relationships between circulating leukocytes and infection in patients with acute leukemia. Ann Int Med 1966;64:328-40.
23. Farrow AC, Buchanan GR, Zwiener RJ, et al. Serum aminotransferase elevation during and following treatment of childhood acute lymphoblastic leukemia. J Clin Oncol 1997; 15:1560-6.
24. Peter JB. Use and interpretation of tests in clinical immunology. Edisi ke-8. USA 1992; 19-21.
25. Raje NS, Rao SR, Iyer RS, et al. Infection analysis in acute lymphoblastic leukemia: a report of 499 consecutive episodes in India (abstract). Pediatr Hematol Oncol 1994; 11 :271-80.
Published
1999-08-30
How to Cite
1.
Harun S, Latupeirissa D, Tambunan T. Pattern of infectious diseases in acute leukemia during induction therapy. PI [Internet]. 30Aug.1999 [cited 23Nov.2024];39(7-8):211-0. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/1772
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Received 2018-02-13
Accepted 2018-02-13
Published 1999-08-30
Accepted 2018-02-13
Published 1999-08-30
