Abstract Objective To examine the clinical features of children with acute lymphoblastic leukemia (ALL) complicated by pulmonary infection after chemotherapy. Methods The clinical data of 108 ALL children (115 case-times) with post-chemotherapy pulmonary infection were retrospectively reviewed. The risk factors for pulmonary infection and the relationship between pathogens and chest CT findings were evaluated. Results The highest incidence (77.4%) of pulmonary infection occurred during remission induction, peaking at 31-60 days after chemotherapy. Patients with neutropenia had the highest incidence rate of pulmonary infection (67.0%). Bacteria (36%) and fungi (41%) were the two most common pathogens in the 41 patients who were etiologically suspected of or diagnosed with pulmonary infection. There was no significant difference in chest CT findings between patients with bacterial and fungal infections. Conclusions The children with ALL are most susceptible to pulmonary infection during remission induction, especially when they are neutropenic. Bacteria and fungi are the main pathogens of pulmonary infections in these patients. However, the changes in chest CT images are poor indicators of the nature of pulmonary infection.
ZHANG Pei-Fen,FENG Xiao-Qin,WU Cui-Ling et al. Clinical features of children with acute lymphoblastic leukemia complicated by pulmonary infection after chemotherapy[J]. CJCP, 2017, 19(12): 1234-1238.
ZHANG Pei-Fen,FENG Xiao-Qin,WU Cui-Ling et al. Clinical features of children with acute lymphoblastic leukemia complicated by pulmonary infection after chemotherapy[J]. CJCP, 2017, 19(12): 1234-1238.
Cheng S, Pole JD, Sung L. Early deaths in pediatric acute leukemia:a population-based study[J]. Leuk Lymphoma, 2014, 55(7):1518-1522.
[2]
Depasse J, Caniza M A, Quessar A, et al. Infections in hospitalized children and young adults with acute leukemia in Morocco[J]. Pediatr Blood Cancer, 2013, 60(6):916-922.
[3]
Taj M, Farzana T, Shah T, et al. Clinical and microbiological profile of pathogens in febrile neutropenia in hematological malignancies:A single center prospective analysis[J]. J Oncol, 2015, 2015:596504.
[4]
Noorifard M, Sekhavati E, Jalaei Khoo H, et al. Epidemiology and clinical manifestation of fungal infection related to Mucormycosis in hematologic malignancies[J]. J Med Life, 2015, 8(Spec Iss 2):32-37.
[5]
Gulati M, Kaur R, Jha V, et al. High-resolution CT in renal transplant patients with suspected pulmonary infections[J]. Acta Radiol, 2000, 41(3):237-241.
Driscoll A J, Deloria Knoll M, Hammitt LL, et al. The effect of antibiotic exposure and specimen volume on the detection of bacterial pathogens in children with pneumonia[J]. Clin Infect Dis, 2017, 64(Suppl 3):S368-S377.
[9]
Chen K, Jia R, Li L, et al. The aetiology of community associated pneumonia in children in Nanjing, China and aetiological patterns associated with age and season[J]. BMC Public Health, 2015, 15:113.
[10]
Inaba H, Pei D, Wolf J, et al. Infection-related complications during treatment for childhood acute lymphoblastic leukemia[J]. Ann Oncol, 2017, 28(2):386-392.
Pagano L, Caira M. Risks for infection in patients with myelodysplasia and acute leukemia[J]. Curr Opin Infect Dis, 2012, 25(6):612-618.
[13]
Biswal S, Godnaik C. Incidence and management of infections in patients with acute leukemia following chemotherapy in general wards[J]. Ecancermedicalscience, 2013, 7:310.
[14]
Hakim H, Flynn PM, Knapp KM, et al. Etiology and clinical course of febrile neutropenia in children with cancer[J]. J Pediatr Hematol Oncol, 2009, 31(9):623-629.
[15]
Ali N, Adil SN, Shaikh MU. Bloodstream and central line isolates from hematopoietic stem cell transplant recipients:data from a developing country[J]. Transpl Infect Dis, 2014, 16(1):98-105.
[16]
Patterson TF, Kirkpatrick WR, White M, et al. Invasive aspergillosis. Disease spectrum, treatment practices, and outcomes. I3 Aspergillus Study Group[J]. Medicine (Baltimore), 2000, 79(4):250-260.
