SEARCH:   Advanced

Blood, 15 November 2007, Vol. 110, No. 10, pp. 3532-3539. Prepublished online as a Blood First Edition Paper on July 27, 2007; DOI 10.1182/blood-2007-05-091942. This Article Full Text Full Text (PDF) All Versions of this Article: blood-2007-05-091942v1 110/10/3532    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Sung, L. Articles by Feusner, J. Search for Related Content PubMed PubMed Citation Articles by Sung, L. Articles by Feusner, J. Related Collections Neoplasia Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Microbiologically documented infections and infection-related mortality in children with acute myeloid leukemia Lillian Sung1, Beverly J. Lange2, Robert B. Gerbing3, Todd A. Alonzo3,4, and James Feusner5 1 Division of Haematology/Oncology, Hospital for Sick Children, Toronto, ON; 2 Division of Oncology, Children's Hospital of Philadelphia, PA; 3 Children's Oncology Group, Arcadia, CA; 4 Division of Biostatistics, University of Southern California, Los Angeles, CA; and 5 Division of Oncology, Children's Hospital of Oakland, CA The primary objective was to describe the prevalence and characteristics of microbiologically defined infections and infection-related mortality (IRM) in 492 children with acute myeloid leukemia enrolled on CCG 2961. Secondary objectives were to determine the relationship between demographic, disease-related, and therapeutic variables, and infections and IRM. Institutions documented infections prospectively. Age, ethnicity, body mass index, leukemia karyotype, treatment, and institutional size were examined for association with infection outcomes. More than 60% of children experienced such infections in each of 3 phases of chemotherapy. There were 58 infectious deaths; cumulative incidence of IRM was 11% plus or minus 2%. Thirty-one percent of infectious deaths were associated with Aspergillus, 25.9% with Candida, and 15.5% with alpha hemolytic streptococci. Age older than 16 years (hazard ratio [HR], 3.32; 95% confidence interval [CI], 1.87-5.89; P < .001), nonwhite ethnicity (HR, 1.85; 95% CI, 1.10-3.09; P = .02), and underweight status (HR, 3.06; 95% CI, 1.51-6.22; P = .002) were associated with IRM, while size of the treating institution was not. Thus, age, ethnicity, and BMI were important contributors to IRM. Fungi and Gram-positive cocci were the most common organisms associated with IRM and, in particular, Aspergillus species was the largest contributor to infectious deaths. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

	Copyright © 2007 by American Society of Hematology         Online ISSN: 1528-0020