Department Of Hematology and Oncology, G. Gaslini Children's Hospital, Genoa, Italy.
Pediatr Blood Cancer. 2010 Dec 1;55(6):1103-7. doi: 10.1002/pbc.22750.
Data on the epidemiology of bacteremias and invasive fungal diseases (IFD) in children with acute myeloid leukemia (AML) are scarce.
In a multi-center, retrospective study, we analyzed proportion, rate per 1,000 person-days at risk, and cumulative risk of bacteremias and IFD in children with AML.
Between January 1998 and December 2005, 240 children were treated for AML at 8 Italian Centers, for a total of 521 treatment courses and 63,232 person-days at risk. Bacteremia was observed in 32% of treatment courses and IFD was seen in 10% (P < 0.0001), with rates of 2.62 and 0.84, respectively (P < 0.001). There was a significantly higher frequency of IFD during relapse treatment: proportion 15% versus 9% (P = 0.05), rate 2.10 versus 0.64 (P = 0.008) and cumulative risk 32% versus 12% (P = 0.007), while there were no differences in the proportion, rate and cumulative risk of bacteremia during front-line or relapse treatment. The epidemiology of bacteremias and IFD was different during front-line therapy for M3 as compared to other types of AML, but the differences were not statistically significant.
Severe infectious complications are frequent during the treatment of pediatric AML, especially during relapse treatment, and bacteremias are more frequent than IFD.
儿童急性髓细胞白血病（AML）患者的菌血症和侵袭性真菌病（IFD）的流行病学数据很少。
在一项多中心、回顾性研究中，我们分析了儿童 AML 患者菌血症和 IFD 的比例、每 1000 人-天的发病率和累积风险。
1998 年 1 月至 2005 年 12 月期间，8 家意大利中心治疗了 240 名 AML 患儿，共有 521 个治疗疗程和 63232 人-天的风险。32%的治疗疗程中观察到菌血症，10%的治疗疗程中观察到 IFD（P<0.0001），发病率分别为 2.62 和 0.84（P<0.001）。复发治疗时 IFD 的频率明显更高：比例为 15%比 9%（P=0.05），发病率为 2.10 比 0.64（P=0.008），累积风险为 32%比 12%（P=0.007），而一线或复发治疗时菌血症的比例、发病率和累积风险无差异。在 M3 与其他类型 AML 的一线治疗中，菌血症和 IFD 的流行病学不同，但无统计学差异。
儿童 AML 治疗期间严重感染并发症频繁，尤其是在复发治疗期间，菌血症比 IFD 更常见。
