UICC World Cancer Congress 2006

Objective:Febrile Neutropenia and documented infections are common with all intensive protocols but there is a paucity of data from Asian countries

Methods:100 patients with neutropenic fever following chemotherapy for acute lymphoblastic leukemia at the Cancer Institute (WIA) from August 2004 to July 2005.

Results:5 patients died of infections. There was no difference in median age, gender ratio, or underlying disease between those who died and those who survived. Bacteria were the main pathogens , and Gram negative organisms predominated. In 152 cycles of chemotherapy, there were 98 febrile neutropenic episodes during the induction and consolidation chemotherapy of acute leukaemia. 65(42.7%) of the episodes had documented infection. 41.3% of organisms causing infection were gram-negative, 31.5% gram-positive, 8% anaerobes , 26% fungi. 6 febrile episodes were associated with pulmonary infiltrates, which progressed to adult respiratory distress syndrome and death in 3 instances. There was no significant occurrence of parasitic and tropical infections (1 tuberculosis and malaria ). Haematological and gastrointestinal side effects and alopecia were expected i.e., developed in >75% of patients. Prednisolone and vincristine induced toxicities were common i.e., observed in >25% of patients. Conclusion: The results show that the pattern of infection, during therapy of acute leukaemia in developing countries, may have important differences when compared with western centres. To improve the long-term event free survival of children with ALL, practitioners must be knowledgeable about the potential spectrum of infections, begin treatment early with appropriate antibiotics, and seek to improve the availability of supportive facilities and modern antibiotics