Infection-related mortality in children with acute lymphoblastic leukemia: an analysis of infectious deaths on UKALL2003

O’Connor, David; Bate, Jessica; Wade, Rachel; Clack, Rachel; Dhir, Sunita; Hough, Rachael; Vora, Ajay; Goulden, Nick; Samarasinghe, Sujith

doi:10.1182/blood-2014-03-560847

Cited by 211 publications

(219 citation statements)

References 30 publications

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“…[23][24][25]33 Historically, Down syndrome ALL (DS-ALL) has been associated with inferior outcome, both with regard to OS and EFS. 34,35 In this study, DS-ALL was associated with very poor outcome, irrespective of the time period (early vs. late period) and the fact that most of these patients were stratified as standard-risk.…”

Section: Discussionmentioning

confidence: 99%

“…8,21 Rigorous selection of patients for the most appropriate treatment intensity is important not only to minimize the risk of subsequent relapses but also to minimize treatment-related toxicity and mortality. [22][23][24][25] Relatively few studies of the long-term outcome after relapsed childhood ALL have been published. Our study cohort is population-based and includes over 500 patients treated according to common up-front protocols, making it, to our best knowledge, the largest of its kind.…”

Section: Introductionmentioning

confidence: 99%

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Relapsed childhood acute lymphoblastic leukemia in the Nordic countries: prognostic factors, treatment and outcome

et al. 2015

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R elapse is the main reason for treatment failure in childhood acute lymphoblastic leukemia. Despite improvements in the up-front therapy, survival after relapse is still relatively poor, especially for high-risk relapses. The aims of this study were to assess outcomes following acute lymphoblastic leukemia relapse after common initial Nordic Society of Paediatric Haematology and Oncology protocol treatment; to validate currently used risk stratifications, and identify additional prognostic factors for overall survival. Altogether, 516 of 2735 patients (18.9%) relapsed between 1992 and 2011 and were included in the study. There were no statistically significant differences in outcome between the up-front protocols or between the relapse protocols used, but an improvement over time was observed. The 5-year overall survival for patients relapsing in the period 2002-2011 was 57.5±3.4%, but 44.7±3.2% (P<0.001) if relapse occurred in the period 1992-2001. Factors independently predicting mortality after relapse included short duration of first remission, bone marrow involvement, age ten years or over, unfavorable cytogenetics, and Down syndrome. T-cell immunophenotype was not an independent prognostic factor unless in combination with hyperleukocytosis at diagnosis. The outcome for early combined pre-B relapses was unexpectedly poor (5-year overall survival 38.0±10.6%), which supports the notion that these patients need further risk adjustment. Although survival outcomes have improved over time, the development of novel approaches is urgently needed to increase survival in relapsed childhood acute lymphoblastic leukemia. Relapsed childhood acute lymphoblastic leukemia in the Nordic countries: prognostic factors, treatment and outcome

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Relapsed childhood acute lymphoblastic leukemia in the Nordic countries: prognostic factors, treatment and outcome

et al. 2015

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“…It has been documented that patients with DS-ALL has high risk of relapse and treatment-related mortality throughout the treatment period independent of the chemotherapy regime [4]. They are also at higher risk for infection-related mortality throughout all treatment phases [5]. Patients with DS-ALL tend to have poorer outcomes than those with No DS-ALL .One reason for previous treatment failures in children with DS-ALL is that these patients tend to develop toxic reactions to therapies In particular, a severe toxicity to methotrexate has been noted [6].…”

Section: Discussionmentioning

confidence: 99%

Acute Leukemia in Down Syndrome Children, A Morroccan Retrospective Review

Ayad¹,

Kababri²,

Kili³

et al. 2017

J Leuk

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“…Due to bone marrow infiltration by lymphocytes, neutro penia is present in patients with ALL, despite the WBC count, making children more prone to infections [15].…”

Section: Correlation Of Initial Laboratory and Clinical Parametersmentioning

confidence: 99%

Correlation between initial blood count and clinical parameters in children with acute lymphoblastic leukemia

Djoric¹,

Benovic²

2015

Med podmladak

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SažetakUvod: ALL je najčešća neoplazma dečje dobi i čini trećinu svih pedijatrijskih maligniteta. Viši proce nat preživljavanja i smanjena incidenca životno ugroža vajućih komplikacija su direktno uslovljeni ranim pre poznavanjem bolesti.Cilj: Cilj studije je da prikaže i međusobno koreli ra inicijalne kliničke i laboratorijske parametre u dece sa ALL.Materijal i metode: Retrospektivna studija je uk ljučila 132 dece, dijagnostikovanih i lečenih po savre menim BFM protokolima. Inicijalna krvna slika je podra zumevala broj leukocita (Le), nivo hemoglobina (Hgb), broj trombocita (Tr) i procenat limfoblasta (LB) u perifer nom razmazu. Od kliničkih parametara na prezentaciji su izdvojeni kao značajni: febrilnost, limfadenopatija, hep atomegalija i splenomegalija.Rezultati: Broj Le se kretao od 10001050000/ μL, Hgb između 40156 g/L i Tr od 0542000/μL. Kod više od pola pacijenata uočen je poremećaj sve tri ćeli jske loze, dok je krvna slika bila u granicama referent nih vrednosti kod dva deteta. Svega sedmoro dece je imalo uredan klinički nalaz. Kod većine pacijenata su febrilnost, limfadenopatija, hepatomegalija i spleno megalija bili prisutni i korelirali su sa Le > 20000/μL, Hgb < 120 g/L i Tr < 50000/μL.Zaključak: Varijacije u kliničkoj slici i laboratori jskim parametrima ukazuju na raznolikost prezentaci je akutne limfoblastne leukemije (ALL) u pedijatrijskoj populaciji. Većina pacijenata ima ili kliničku sliku ili poremećaj parametara krvne slike koji pobuđuju sumnju na ALL, ali je izazov prepoznati pacijente sa odsustvom kliničkih simptoma i laboratorijskim nalazima unutar ref erentnih granica za uzrast. Po našim saznanjima, ovo je prva studija koja ispituje inicijalne kliničke i laboratori jske parametre u dece sa ALL u Srbiji. Želimo da ukaže mo na značaj ranog prepoznavanja simptoma i znaka ove bolesti.Ključne reči: akutna limfoblastna leukemija, deca, klinički nalaz, laboratorijski parametri Abstract Introduction: ALL is the most common malig nancy in children, accounting for one third of all pedi atric cancer patients. It is of crucial importance to rec ognise the disease on time to ensure good outcome and prevent initial complications.Aim: Study aim was to correlate blood count and clinical parameters on diagnosis in children with ALL.Material and Methods: Retrospective study in cluded 132 children, diagnosed and treated according to current BFM protocols. Initial blood analysis included leukocyte count (WBC), hemoglobin level (Hgb), plate let count (Plt) and percent of lymphoblasts in peripheral smear. Initial clinical parameters included fever, lymph adenopathy, hepatomegaly and splenomegaly.Results: WBC ranged from 1000 1050000/μL, Hgb between 40 156 g/L and Plt from 0 542000/μL. More than half of the children had all three lineages af fected, while CBC within reference range was found in two patients. Only seven children had normal clinical findings. In majority of patients fever, lymphadenopathy, hepatomegaly and splenomegaly was present and strong ly correlated with WBC > 20000/μL, Hgb < 120 g/L and...

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Infection-related mortality in children with acute lymphoblastic leukemia: an analysis of infectious deaths on UKALL2003

Cited by 211 publications

References 30 publications

Relapsed childhood acute lymphoblastic leukemia in the Nordic countries: prognostic factors, treatment and outcome

Relapsed childhood acute lymphoblastic leukemia in the Nordic countries: prognostic factors, treatment and outcome

Acute Leukemia in Down Syndrome Children, A Morroccan Retrospective Review

Correlation between initial blood count and clinical parameters in children with acute lymphoblastic leukemia

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