Publication Date:
2009-11-20
Description:
Abstract 983 Poster Board I-5 Introduction: Tailored, intensified therapy has led to improved survival of pediatric acute lymphoblastic leukemia (ALL). However, intensified therapy leads to more infectious morbidity. The aim of this study is to investigate to what extent less intensive therapy in good risk patients decreases infectious morbidity. Patients and Methods: 203 children newly diagnosed with ALL between 1 and 19 years old were included in all 8 University Medical Centers in the Netherlands between 2004 and 2007 and followed prospectively until end of treatment. All patients kept a diary by which admittances for infection were reported. All these admittances were systematically reviewed by the investigators in the clinical files. Infections occurring during hospital stay for other indications (e.g. chemotherapy) or present at the time of diagnosis of ALL were also recorded but not included in this analysis. Patients were stratified into 3 arms identical to BFM-2000 criteria with a reduced treatment for good risk patients: standard risk (SR), an intensified reinduction treatment for medium risk patients (MR) and series of intensive courses of chemotherapy in most cases combined with allogeneic stem cell transplantation for high risk patients (HR). Statistics: All variables were corrected for patient time in study (standard 104 weeks). After logarithmic transformation data was evaluated using ANOVA. Results: 55 children were stratified to SR group, 123 to MR group and 21 to HR group. SR patients were followed for a mean of 102 weeks, MR 100 weeks and HR 47 weeks. A total of 507 admittances for infection were recorded. SR patients were admitted 1.1 times on average, versus 3.4 for MR and 6.9 for HR patients (p
Print ISSN:
0006-4971
Electronic ISSN:
1528-0020
Topics:
Biology
,
Medicine
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