PT  - JOURNAL ARTICLE
AU  - Meir, Hadir M.
AU  - Balawi, Ibrahim A.
AU  - Meer, Hala M.
AU  - Nayel, Hala
AU  - Al-Mobarak, Mohammad F.
TI  - Fever and granulocytopenia in children with Acute Lymphoblastic Leukemia under induction therapy
DP  - 2001 May 01
TA  - Saudi Medical Journal
PG  - 423--427
VI  - 22
IP  - 5
4099  - http://smj.org.sa/content/22/5/423.short
4100  - http://smj.org.sa/content/22/5/423.full
SO  - Saudi Med J2001 May 01; 22
AB  - OBJECTIVE: Infection is one of the most serious complications of cancer therapy. The rationale of using broad spectrum antibiotics prophylactically has led to a great change in the causative organisms. The aim of the present study is to review retrospectively the type and sequence of infectious complications among Saudi children with acute lymphoblastic leukemia.METHODS: A total of 233 febrile episodes were observed in 137 children with acute lymphoblastic leukemia under induction therapy using modified BFM protocol were studied.RESULTS: Profound neutropenia (Absolute Neutrophil count < 100/mm3) was encountered in 72 episodes (31%). Clinical signs and symptoms suggestive of infection were evident in 39% of the neutropenic episodes. The respiratory system was the most frequently affected site encountered in 17% of the episodes. Microbiologically documented infection was recorded in 59% (n=137) of the fever and granulocytopenia episodes. In 96 episodes (41%), there was neither clinical nor microbiological evidence of infection fever of unknown origin. Out of the 932 cultures, positive isolates were detected in 346 cultures (37%). Gram positive cocci were the most frequently organisms (54%) followed by gram negative bacilli (39%). In the current study, 7 patients (3%) died because of direct or indirect consequences of infection.CONCLUSION: The current study stresses the importance of frequent reviewing of the type, frequency, severity and outcome of infection complications over years to detect changing epidemiological patterns.