Infectious complications in children with acute lymphoblastic leukemia treated in low-middle-income countries

Caniza, Miguela; Odio, Carla; Mukkada, Sheena; González, Miriam; Ceppi, Francesco; Chaisavaneeyakorn, Sujittra; Apiwattanakul, Nopporn; Howard, Scott C.; Conter, Valentino; Bonilla, Miguel

doi:10.1586/17474086.2015.1071186

Cited by 31 publications

(32 citation statements)

References 127 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Low‐ and middle‐income countries (LMICs) and developing economies do not have the excellent outcomes as reported by the industrialized nations . The reasons include lack of adequate supportive care, malnutrition, higher proportion with adverse prognostic factors, abandonment and high incidence of toxic deaths . In addition, late presentation is also perceived to be a factor influencing the outcome.…”

Section: Introductionmentioning

confidence: 99%

“…3 The reasons include lack of adequate supportive care, malnutrition, Abbreviations: ALL, acute lymphoblastic leukemia; CNS, central nervous system; CR, complete remission; EFS, event-free survival; HIC, high-income country; IQR, interquartile range; LMIC, low-and middle-income country; NCI, National Cancer Institute; OS, overall survival; RR, rate ratio; TLC, total leucocyte count; TRM, treatment-related mortality; UMIC, upper middle income country higher proportion with adverse prognostic factors, abandonment and high incidence of toxic deaths. 1,[3][4][5][6] In addition, late presentation is also perceived to be a factor influencing the outcome. Most centers in developing/LMIC countries follow protocols developed in highincome countries (HICs).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Improving outcome of acute lymphoblastic leukemia with a simplified protocol: report from a tertiary care center in north India

Trehan

Bansal

Varma

et al. 2016

Pediatr Blood Cancer

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Improving outcome of acute lymphoblastic leukemia with a simplified protocol: report from a tertiary care center in north India

Trehan

Bansal

Varma

et al. 2016

Pediatr Blood Cancer

View full text Add to dashboard Cite

show abstract

“…Perceived barriers to the practice of HH were insufficient time, negative reaction when giving reminders for HH, inconsistent presence of supplies, inconsistent HH training, suboptimal peer and supervisor HH practices and social norms, and patients’ and families’ limited knowledge about preventing infection. These challenges at UNOP are also frequently encountered at other centers in LMICs [25] and should be specifically addressed by IPC teams and healthcare institutions leaders to increase compliance over the long term.…”

Section: Discussionmentioning

confidence: 99%

Understanding hand hygiene behavior in a pediatric oncology unit in a low- to mid-income country

González

Finerman

Johnson

et al. 2016

JNEP

View full text Add to dashboard Cite

Background/Objective A qualitative method study identified perceived barriers and motivations for hand hygiene (HH) practice in a pediatric oncology unit in Guatemala. Methods Data collection included focus groups with participants grouped by job type. Focus group responses were assessed using content analysis. Participants included nurse supervisors, registered nurses, auxiliary nurses, physicians, and auxiliary and support staff and volunteers (n=55). Results Themes emerged from participant responses, providing a framework to develop and implement targeted interventions to improve HH. Perceived barriers to HH included the following themes: inconsistent HH supplies, time pressures related to workload, lack of HH training for some healthcare workers and patients’ families; negative social reactions after reminding others to practice HH; and cultural traditions shaping patients’ families’ hygiene. Motivations for HH practice included two themes: patient protection and self-protection. Some of these themes were unique to this culture and clinical setting. Recommendations included a preference for visual aids rather than verbal reminders (e.g. HH promotion signage, demonstrations of HH), and disclosure of compliance rates. Conclusions The research team concluded that the main barriers and motivations for HH, including culturally-unique and site-specific factors, were identified and used for subsequent HH compliance improvement such as education. Intervention post focus group concentrated in HH education of healthcare providers using e-learning methodology.

show abstract

“…For example, for children treated for ALL, the rates of infection-associated mortality are up to 10-times higher in low-and middle-income countries than in high-income countries. 18 This is due to several underlying factors such as shortage of trained personnel, supplies, diagnostic tools, and adequate infrastructures as well as undernourishment and risk of multiple drug-resistant organisms (MDROs). 18 Also, in high-income countries, socioeconomic status seems to be a risk factor for infection and early complications in acute leukemia patients.…”

mentioning

confidence: 99%

“…18 This is due to several underlying factors such as shortage of trained personnel, supplies, diagnostic tools, and adequate infrastructures as well as undernourishment and risk of multiple drug-resistant organisms (MDROs). 18 Also, in high-income countries, socioeconomic status seems to be a risk factor for infection and early complications in acute leukemia patients. 19 Finally, lower early mortality is also registered in centers with larger patients' volume and more special cancer centers.…”

mentioning

confidence: 99%

Febrile Neutropenia in Acute Leukemia. Epidemiology, Etiology, Pathophysiology and Treatment

Hansen¹,

Wendelbo²,

Bruserud³

et al. 2019

Mediterr J Hematol Infect Dis

View full text Add to dashboard Cite

Acute leukemias are a group of aggressive malignant diseases associated with a high degree of morbidity and mortality. An important cause of both the latter is infectious complications. Patients with acute leukemia are highly susceptible to infectious diseases due to factors related to the disease itself, factors attributed to treatment, and specific individual risk factors in each patient. Patients with chemotherapy-induced neutropenia are at particularly high risk, and microbiological agents include viral, bacterial and fungal agents. The etiology is often unknown in infectious complications, although adequate patient evaluation and sampling have diagnostic, prognostic and treatment-related consequences. Bacterial infections include a wide range of potential microbes, both Gram-negative and Gram-positive species, while fungal infections include both mold and yeast. A recurring problem is increasing resistance to antimicrobial agents, and in particular, this applies to extended-spectrum beta-lactamase resistance (ESBL), Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE) and even carbapenemase-producing Enterobacteriaceae (CPE). International guidelines for the treatment of sepsis in leukemia patients include the use of broad-spectrum Pseudomonas-acting antibiotics. However, one should implant the knowledge of local microbiological epidemiology and resistance conditions in treatment decisions. Here, we discuss infectious diseases in acute leukemia with a major focus on febrile neutropenia and sepsis, and we problematize the diagnostic, prognostic, and therapeutic aspects of infectious complications in this patient group. Meticulously and thorough clinical and radiological examination combined with adequate microbiology samples are cornerstones of the examination. Diagnostic and prognostic evaluation includes patient review according to the multinational association for supportive care in cancer (MASCC) and sequential organ failure assessment (SOFA) scoring system. Antimicrobial treatments for important etiological agents are presented. The main challenge for reducing the spread of resistant microbes is to avoid unnecessary antibiotic treatment, but without giving to narrow treatment to the febrile neutropenic patient that reduce the prognosis.

show abstract

Infectious complications in children with acute lymphoblastic leukemia treated in low-middle-income countries

Cited by 31 publications

References 127 publications

Improving outcome of acute lymphoblastic leukemia with a simplified protocol: report from a tertiary care center in north India

Improving outcome of acute lymphoblastic leukemia with a simplified protocol: report from a tertiary care center in north India

Understanding hand hygiene behavior in a pediatric oncology unit in a low- to mid-income country

Febrile Neutropenia in Acute Leukemia. Epidemiology, Etiology, Pathophysiology and Treatment

Contact Info

Product

Resources

About