Infections in children and adolescents with Acute Leukemia

Abstract

The incidence and spectrum of infections in pediatric leukemia patients vary depending on the type of leukemia. AML, which involves intensive chemotherapeutic regimes, leads to profound and prolonged neutropenia, making children more susceptible to infection. The intensity of chemotherapy, the duration of neutropenia, and antimicrobial prophylaxis implementation all affect the risk of life-threatening infections. In AML studies have shown that during intensive treatment, children experience more than one episode of infection, with majority being bacteremias. Viridans group Streptococci comprises around 20% of all isolates. Infection related deaths range from 5.4% to 7.3% during chemotherapy being more frequent on intensive phase. Invasive fungal infections (IFI) were highly associated with mortality specially caused by Aspergillus spp. In ALL induction and consolidation phases posing a higher risk for infections due to severe neutropenia. Infection related mortality in ALL is 2–4%, and infections are the main cause of treatment related deaths. IFI are significant concern with risk factors including age and treatment intensity. High risk include older children, delayed response during early induction therapy and corticosteroid administration. In summary, while survival rates for childhood leukemia have improved, the risk of infections, particularly bacterial and fungal infections, remains a significant concern, especially during intensive treatment phases. Ongoing research is needed to better understand and manage these infections in pediatric leukemia patients