Infectious Complication During Induction Chemotherapy in Children with Acute Myeloid Leukemia- A Single Center Study

Authors

  • Indira Chowdhury Assistant Professor, Pediatric Hematology and Oncology, Chattogram Maa O Sishu Hospital Medical College, Bangladesh
  • Chowdhury Yakub Jamal Professor, Department of Pediatric Hematology and Oncology, BSMMU, Bangladesh
  • Shahinoor Akter Soma Junior Consultant ( Pediatrics), National Center for Control of Rheumatic Fever and Heart Disease, Dhaka, Bangladesh
  • Farah Diba Junior Consultant (Paediatrics), UHC, Keraniganj, Dhaka, Bangladesh
  • Imrul Kaes Assistant Professor (Paediatric Hematology and Oncology), Khwaja Yunus Ali Medical College and Hospital, Bangladesh
  • Zaved Mahmud IMO (Pediatrics), Khulna Medical College Hospital, Bangladesh

DOI:

https://doi.org/10.3329/bjch.v45i3.62877

Keywords:

Acute Myeloid Leukemia (AML), Febrile Neutropenia, Septicemia

Abstract

Background: Acute Myeloid Leukemia (AML) contributes to about 20% of leukemia. Most of the AML patients suffer from infection.

Objective: To evaluate the rate of infection, type and site of infection, organisms responsible for infection and to assess antibiotic sensitivity pattern and infection related mortality in AML.

Material & Methods: Newly diagnosed AML patients aged between 1-18 years, admitted to receive induction chemotherapy were enrolled. They received induction of chemotherapy according to Modified MRC’ 12 in our department. Patient was on followup throughout the induction period and all the infectious complication occurred during this period were analyzed.

Result: A total of 38 episodes of infection developed in 34 patients in both cycles of induction (1.12 episodes/ patient). Among the total 38 episodes of infection, fever was the commonest clinical presentation. In both chemotherapy cycles, 7(18.4%) episodes of infection were culture positive. A total of 9 organisms were isolated of which most of them was gram-negative. Fever without focus was found in 15(39.5%) episodes. Profound neutropenia was present in 15(39.47%) episodes and profound neutropenic episodes were found to be culture positive in 5(71.4%) cases. About 6(17.5%) patients died during 1st cycle of induction.

Conclusion: Among children with AML, profound neutropenic cases had high susceptibility to culture positive infection. Further prospective study is needed to identify means to prevent infectious complication of AML patients receiving induction chemotherapy particularly in those with profound neutropenia.

BANGLADESH J CHILD HEALTH 2021; VOL 45 (3) : 134-140

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Published

2022-11-20

How to Cite

Chowdhury, I. ., Jamal, C. Y. ., Soma, S. A. ., Diba, F. ., Kaes, I. ., & Mahmud, Z. . (2022). Infectious Complication During Induction Chemotherapy in Children with Acute Myeloid Leukemia- A Single Center Study. Bangladesh Journal of Child Health, 45(3), 134–140. https://doi.org/10.3329/bjch.v45i3.62877

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Original Articles