Acute respiratory illness in children with acute lymphoblastic leukemia

Iacuone, John J.; Wong, Kwan Y.; Bove, Kevin E.; Lampkin, Beatrice C.

doi:10.1016/s0022-3476(77)80558-1

Cited by 10 publications

(2 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…On the other hand, no episode of carinii or interstitial pneumonia occurred before the 40th day of antileukemic therapy, and 25 of the 30 episodes occurred between the 40th and 120th days. These results are similar to those recently reported by Ruebush et al2,i and Iacuone et al 7 The cause of this remarkable increase in incidence of carinii pneumonia at this point in the therapy of ALL, particularly in patients receiving IT methotrexate for CNS prophylaxis (regimens 3 and 4), can¬ not be clarified in the present retro¬ spective study. In contrast to the report of Iacuone et al,7 lymphopenia did not play a role in this phenomenon in our patients.7 Chemotherapeutic agents, particularly methotrexate and corticosteroids, have been shown to cause abnormalities to tissue macro¬ phage function, but further prospec¬ tive evaluations in children with ALL are necessary to determine if such a mechanism is related to the present findings.272*…”

Section: Commentsupporting

confidence: 91%

Pneumonia During Therapy for Childhood Acute Lymphoblastic Leukemia

Siegel¹

1980

Arch Pediatr Adolesc Med

View full text Add to dashboard Cite

\s=b\The incidence of pneumonia was evaluated in 844 children undergoing initial treatment for acute lymphoblastic leukemia (ALL). A total of 310 episodes occurred in 239 patients followed up for five to 36 months after diagnosis. The peak incidences occurred in the periods 0 to 20 days and 40 to 80 days after the start of antileukemic therapy. Bacterial pneumonias occurred primarily during the first 20 days after diagnosis of ALL. No episode of Pneumocystis carinii pneumonia was noted before 40 days, and the majority of instances occurred 50 to 120 days after diagnosis. In 80% of all episodes, a specific causative organism was not detected. The incidence of P carinii pneumonia was greater in patients receiving intrathecal methotrexate as part of CNS prophylaxis than in those receiving only CNS irradiation. Pneumonia is a frequent event during the therapy of ALL in childhood.(Am J Dis Child 134: [28][29][30][31][32][33][34] 1980) Pul monary infections frequently occur during the therapy of acute leukemia and other malignancies of the hemopoietic system, often result¬ ing in interruption of intensive chem¬ otherapy programs and/or in death.17 According to the literature, pneumo¬ nia accounts for 28% to 43% of all fatal and nonfatal infections in these patients.'Ii Bacterial and fungal orga¬ nisms comprise more than 90% of all the documented etiologic agents, al¬ though viruses and protozoans are recovered more frequently than from normal age-matched patient popula¬ tions'3 and are the most common causes of death due to pneumonia in some series.6 In addition, the direct pulmonary effects of radiation and specific chemotherapeutic agents, such as methotrexate, have been increasingly implicated in these pro¬ cesses as they are incorporated into standard treatment regimens for acute leukemia.818Previous studies of pulmonary dis¬ ease in acute leukemia have consisted of investigations that stress severe or fatal episodes in relatively small patient populations.1 •-•e·7·-" To deter¬ mine the frequency and characteris¬ tics of pulmonary disease during the therapy of childhood acute lympho¬ blastic leukemia (ALL) in a large representative population and to iden¬ tify factors contributing to the devel¬ opment of pulmonary complications, an evaluation was conducted by the Childrens Cancer Study Group (CCSG) as an integral part of an ongo¬ ing treatment program for childhood ALL. SUBJECTS AND METHODS Patient PopulationAll patients aged birth to 16 years entered on CCSG protocols 101 and 143 were eligible for this study. Three standard phases of therapy are identified for both protocols: induction, intensification, and maintenance. Protocol CCSG-101 (Fig 1) was designed, in part, to determine the most effective and least toxic means of controlling extramedullary disease in ALL by randomizing patients who attain bonemarrow remission status to one of four intensification regimens, as follow: regi¬ men 1, craniospinal irradiation 2,400 rads and 1,200 rads to an "extended" field that includes total abdomen and pelvis (the t...

show abstract

Section: Commentsupporting

confidence: 91%

Pneumonia During Therapy for Childhood Acute Lymphoblastic Leukemia

Siegel¹

1980

Arch Pediatr Adolesc Med

View full text Add to dashboard Cite

show abstract

“…Cancer and its associated therapies can result in significant noninfectious pulmonary pathology including malignant infiltration, radiation-, and drug-induced injury. More importantly, treatment associated immunosuppression significantly increases the risk for respiratory infections [1][2][3][4]. The optimal diagnostic approach for cancer patients with pulmonary complications remains unclear.…”

Section: Introductionmentioning

confidence: 99%

Clinical utility of bronchoalveolar lavage in pediatric cancer patients

Park

Fogarty

Brogan

2002

Med. Pediatr. Oncol.

View full text Add to dashboard Cite

show abstract

Pediatric Cough: Children Are Not Miniature Adults

Chang

2009

Lung

View full text Add to dashboard Cite

Pediatric cough-related issues, like most other conditions in particularly young children, share similarities but also have substantial important differences with adults. These can be understood from physiologically based domains simplified to (1) cough-specific, (2) general respiratory, (3) other direct systems such as the immune system, and (4) other general physiology. Among other reasons, these result in observed differences in etiology, management, and measurement of response between children and adults. For example, while empirical therapy for chronic cough is widely advocated for adults, it is not advocated for children. Indeed, there is some evidence that an empirical approach is potentially harmful; this is related to the use of medications and the delay in obtaining a correct diagnosis such as missed foreign body aspiration.

show abstract

Acute respiratory illness in children with acute lymphoblastic leukemia

Cited by 10 publications

References 7 publications

Pneumonia During Therapy for Childhood Acute Lymphoblastic Leukemia

Pneumonia During Therapy for Childhood Acute Lymphoblastic Leukemia

Clinical utility of bronchoalveolar lavage in pediatric cancer patients

Pediatric Cough: Children Are Not Miniature Adults

Contact Info

Product

Resources

About