Department of Pediatric Oncology, Hematology and Transplantology, University of Medical Sciences, Poznan, Poland.
Department of Pediatric Hematology and Oncology, Medical University, Warszawa, Poland.
Leuk Lymphoma. 2019 Dec;60(12):3028-3035. doi: 10.1080/10428194.2019.1616185. Epub 2019 May 28.
The aim of this nationwide study was to describe the epidemiology and profile of bacterial infections (BI), invasive fungal disease (IFD) and viral infections (VI) in patients with and relapsed/refractory (rel/ref) acute myeloid leukemia (AML). Within the studied group of 250 children with primary AML, at least one infectious complication (IC) was diagnosed in 76.0% ( = 190) children including 85.1% ( = 504) episodes of BI, 8.3% ( = 49) - IFD and 6.6% ( = 39) - VI. Among 61 patients with rel/ref AML, at least one IC was found in 67.2% ( = 41) of children including 78.8% ( = 78) of BI, 14.1% ( = 14) of IFD and 7.1% ( = 7) of VI. In all AML patients, within BI Gram-negative strains were predominant. Half of these strains were multi-drug resistant. Characteristics of IFD and VI were comparable for de novo and rel/ref AML. The infection-related mortality was significantly higher, while survival from infection was significantly lower in patients with rel/ref disease.
这项全国性研究的目的是描述初发和复发/难治性急性髓系白血病（AML）患者的细菌感染（BI）、侵袭性真菌病（IFD）和病毒感染（VI）的流行病学和特征。在研究的 250 例初发 AML 患儿中，76.0%（ = 190）的患儿至少发生了 1 次感染并发症（IC），包括 85.1%（ = 504）次 BI、8.3%（ = 49）次 IFD 和 6.6%（ = 39）次 VI。在 61 例复发/难治性 AML 患儿中，67.2%（ = 41）的患儿至少发生了 1 次 IC，包括 78.8%（ = 78）次 BI、14.1%（ = 14）次 IFD 和 7.1%（ = 7）次 VI。在所有 AML 患儿中，BI 以革兰氏阴性菌株为主，其中一半菌株为多药耐药菌。新发和复发/难治性 AML 的 IFD 和 VI 特征相当。复发/难治性疾病患儿的感染相关死亡率显著更高，而感染后的生存率显著更低。
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