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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 (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 HighWire 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. Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted May 24, 2007 Accepted July 25, 2007 Microbiologically documented infections and infection-related mortality in children with acute myeloid leukemia Lillian Sung*, Beverly J Lange, Robert B. Gerbing, Todd A Alonzo, and James Feusner Divisioin of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, PA, United States Children's Oncology Group, Arcadia, CA, United States Division of Biostatistics, University of Southern California, Los Angeles, CA, United States Division of Oncology, Children's Hospital Oakland, Oakland, CA, United States * Corresponding author; email: lillian.sung{at}sickkids.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. Over 60% of children experienced such infections in each of three phases of chemotherapy. There were 58 infectious deaths; cumulative incidence of IRM was 11±2%. Thirty-one percent of infectious deaths were associated with Aspergillus, 25.9% with Candida, and 15.5% with alpha haemolytic streptococci. Age over sixteen years (hazard ratio [HR] 3.32, 95% confidence interval [CI] 1.87, 5.89; P<.001), non-white 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? This article has been cited by other articles: L. Potenza, P. Barozzi, G. Rossi, G. Palazzi, D. Vallerini, G. Riva, M. Cellini, M. Morselli, F. Volzone, C. Venturelli, et al. Assessment of Aspergillus-Specific T Cells for Diagnosis of Invasive Aspergillosis in a Leukemic Child with Liver Lesions Mimicking Hepatosplenic Candidiasis Clin. Vaccine Immunol., October 1, 2008; 15(10): 1625 - 1628. [Abstract] [Full Text] [PDF]

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