High Infection-Related Mortality in Pediatric Acute Myeloid Leukemia without Preventive Antibiotics and Antifungals: Retrospective Cohort Study of a Single Center from a Middle-Income Country

摘要

Objective: This study aimed to evaluate infection-related mortalityin patients with acute myeloid leukemia (AML) treated withoutpreventive antibiotics and antifungals in a middle-income country.Materials and Methods: Infection-related mortality was evaluatedretrospectively in 49 pediatric patients.Results: A total of 173 chemotherapy courses were administered asfirst-line chemotherapy. Four patients died during induction: onepatient due to intracranial bleeding, two patients due to typhlitis,and one patient due to invasive fungal infection with pulmonaryvascular invasion and massive bleeding. Another two patients diedwith resistant disease. During consolidation there were four infectionrelateddeaths and one death due to cardiotoxicity. In first-linechemotherapy mortality was 22% (11/49); infection-related mortalitywas 14% (7/49). Event-free survival and overall survival at 6 years were42.9% and 61.2% (95% CI: 44-76 and 66-99 months), respectively.Conclusion: Due to considerable infection-related deaths,antibacterial and mold-active antifungal prophylaxis may be triedduring neutropenic periods in pediatric AML.