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. 1981 Nov;56(11):841–844. doi: 10.1136/adc.56.11.841

Serious infections during continuing treatment of acute lymphoblastic leukaemia.

J Ninane, J M Chessells
PMCID: PMC1627408  PMID: 6946728

Abstract

Seventy-six of 168 children with acute lymphoblastic leukaemia, who had completed induction therapy and central nervous system prophylaxis, were each admitted to hospital at least once during subsequent treatment with an infectious illness. The time spent in hospital was calculated as a proportion of the total number of days at risk and had a mean value of one day in 75. Sixty-three (37%) children spent longer than this in hospital, particularly patients younger than 5 years and those on a more intensive protocol; a third year of treatment appeared to carry no significant addition risk of infection. Death due to infection occurred in 14 (8.3%) children; these deaths were more common in younger patients and during the first 2 years of treatment and were mainly due to measles, septicaemia, or cytomegalovirus. These findings show that younger children and those receiving more intensive treatment are at greater risk of infection. The risk is not one of exotic infections, but of measles, a preventable disease.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Asano Y., Nakayama H., Yazaki T., Kato R., Hirose S. Protection against varicella in family contacts by immediate inoculation with live varicella vaccine. Pediatrics. 1977 Jan;59(1):3–7. [PubMed] [Google Scholar]
  2. Chessells J. M., Hardisty R. M., Rapson N. T., Greaves M. F. Acute lymphoblastic leukaemia in children: Classification and prognosis. Lancet. 1977 Dec 24;2(8052-8053):1307–1309. doi: 10.1016/s0140-6736(77)90361-0. [DOI] [PubMed] [Google Scholar]
  3. Chessells J. M., Leiper A. D. Infection during remission induction in childhood leukaemia. Arch Dis Child. 1980 Feb;55(2):118–123. doi: 10.1136/adc.55.2.118. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Craft A. W., Reid M. M., Bruce E., Kernahan J., Gardner P. S. Role of infection in the death of children with acute lymphoblastic leukaemia. Arch Dis Child. 1977 Oct;52(10):752–757. doi: 10.1136/adc.52.10.752. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Eiser C. How leukaemia affects a child's schooling. Br J Soc Clin Psychol. 1980 Nov;19(Pt 4):365–368. doi: 10.1111/j.2044-8260.1980.tb00366.x. [DOI] [PubMed] [Google Scholar]
  6. Feldman S., Hughes W. T., Daniel C. B. Varicella in children with cancer: Seventy-seven cases. Pediatrics. 1975 Sep;56(3):388–397. [PubMed] [Google Scholar]
  7. Hughes W. T. Editorial: Treatment of Pneumocystis carinii pneumonitis. N Engl J Med. 1976 Sep 23;295(13):726–727. doi: 10.1056/NEJM197609232951311. [DOI] [PubMed] [Google Scholar]
  8. MITUS A., HOLLOWAY A., EVANS A. E., ENDERS J. F. Attenuated measles vaccine in children with acute leukemia. Am J Dis Child. 1962 Mar;103:413–418. doi: 10.1001/archpedi.1962.02080020425051. [DOI] [PubMed] [Google Scholar]
  9. MacLennan I. C., Kay H. E., Festenstein M., Smith P. G. Analysis of treatment in childhood leukaemia. II. Timing and the toxicity of combined 6-mercaptopurine and methotrexate maintenance therapy. Br J Haematol. 1976 Jun;33(2):179–188. doi: 10.1111/j.1365-2141.1976.tb03529.x. [DOI] [PubMed] [Google Scholar]
  10. MacLennan I. C., Peto J., Kay H. E. Analysis of treatment of childhood leukaemia. V. Advantage of reduced chemotherapy during and immediately after cranial irradiation. Br J Cancer. 1977 Nov;36(5):625–633. doi: 10.1038/bjc.1977.240. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Pullan C. R., Noble T. C., Scott D. J., Wisniewsk K., Gardner P. S. Atypical measles infections in leukaemic children on immunosuppressive treatment. Br Med J. 1976 Jun 26;1(6025):1562–1565. doi: 10.1136/bmj.1.6025.1562. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Rapson N. T., Cornbleet M. A., Chessells J. M., Bennett A. J., Hardisty R. M. Immunosuppression and serious infections in children with acute lymphoblastic leukaemia: a comparison of three chemotherapy regimes. Br J Haematol. 1980 May;45(1):41–52. doi: 10.1111/j.1365-2141.1980.tb03809.x. [DOI] [PubMed] [Google Scholar]
  13. Schaeffer H. J., Beauchamp L., de Miranda P., Elion G. B., Bauer D. J., Collins P. 9-(2-hydroxyethoxymethyl) guanine activity against viruses of the herpes group. Nature. 1978 Apr 13;272(5654):583–585. doi: 10.1038/272583a0. [DOI] [PubMed] [Google Scholar]
  14. Siegel S. E., Nesbit M. E., Baehner R., Sather H., Hammond G. D. Pneumonia during therapy for childhood acute lymphoblastic leukemia. Am J Dis Child. 1980 Jan;134(1):28–34. doi: 10.1001/archpedi.1980.02130130020007. [DOI] [PubMed] [Google Scholar]
  15. Simone J. V., Holland E., Johnson W. Fatalities during remission of childhood leukemia. Blood. 1972 Jun;39(6):759–770. [PubMed] [Google Scholar]

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