ASSESSMENT OF FEBRILE NEUTROPENIA EPISODES IN CHILDREN WITH ACUTE LEUKEMIA TREATED WITH BFM PROTOCOLS

• Published in: Pediatric hematology and oncology Vol. 25; no. 3; pp. 195 - 204
• Main Authors: Y lmaz, ebnem, Ören, Hale, Demircio lu, Fatih, i rken, Gülersu
• Format: Journal Article
• Language: English
• Published: England Informa UK Ltd 01.01.2008; Taylor & Francis
• Subjects: Adolescent; Anti-Bacterial Agents - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Asparaginase - administration & dosage; Bacteremia - drug therapy; Bacteremia - etiology; Child; Child, Preschool; Daunorubicin - administration & dosage; febrile neutropenia; Female; granulocyte colony-stimulating factor; Granulocyte Colony-Stimulating Factor - administration & dosage; Humans; Infant; Infant, Newborn; leukemia; Leukemia, Myeloid, Acute - complications; Leukemia, Myeloid, Acute - drug therapy; Male; Mucositis - drug therapy; Mucositis - etiology; Neutropenia - drug therapy; Neutropenia - etiology; Prednisone - administration & dosage; Retrospective Studies; Risk Factors; Time Factors; Vincristine - administration & dosage
• ISSN: 0888-0018; 1521-0669
• DOI: 10.1080/08880010801938231

The authors overviewed 239 febrile neutropenia (FN) episodes in 82 pediatric leukemia cases treated with BFM treatment protocols. FN was observed mostly during consolidation therapy. Mucositis was the most identified focus; gram-negative microorganisms were the most identified pathogens. Five patients developed invasive fungal infections. Fever resolved after mean 5.3 days and mean antibiotic administration time was 12.7 days. Addition of G-CSF to antimicrobial therapy shortened the duration of neutropenia, but it did not affect duration of fever resolution and antibiotic administration. The duration of neutropenia, fever resolution, and antibiotic administration was significantly longer in children with acute myeloid leukemia. The authors conclude that children with acute leukemia have severe prolonged neutropenia and are in high risk. In these patients, prediction of the risk of bacteremia based on clinical and laboratory features is important for immediate empiric broad-spectrum antimicrobial therapy and for higher survival rate.