Document Detail


Early and treatment-related deaths in childhood acute myeloid leukaemia in the Nordic countries: 1984-2003.
MedLine Citation:
PMID:  20955398     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Despite major improvements in the cure rate of childhood acute myeloid leukaemia (AML), 5-15% of patients still die from treatment-related complications. In a historical prospective cohort study, we analysed the frequency, clinical features and risk factors for early deaths (ED) and treatment-related deaths (TRD) in 525 children included in the Nordic Society of Paediatric Haematology and Oncology (NOPHO)-AML-84, -88 and -93 trials. Seventy patients (13%) died before starting treatment or from treatment-related complications. The death rate rose from 11% in NOPHO-AML-84 to 29% in -88, but then fell to 8% in -93. Sixteen patients (3%) died within the first 2 weeks, mainly from bleeding or leucostasis. Hyperleucocytosis, age <2 or ≥10 years were risk factors. After day 15, 10% of patients died from treatment-related complications with infection as the main cause of death. Risk factors were age <2 or ≥10 years and treatment according to the NOPHO-AML-88 protocol. The number of EDs and TRDs in AML is high. Therefore optimal antifungal prophylaxis is essential, and studies on the benefit of antibacterial prophylaxis and individual risk factors for ED and TRD are needed.
Authors:
Lene Molgaard-Hansen; Merja Möttönen; Heidi Glosli; Guðmundur K Jónmundsson; Jonas Abrahamsson; Henrik Hasle;
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Publication Detail:
Type:  Journal Article; Multicenter Study     Date:  2010-10-19
Journal Detail:
Title:  British journal of haematology     Volume:  151     ISSN:  1365-2141     ISO Abbreviation:  Br. J. Haematol.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-12     Completed Date:  2011-01-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372544     Medline TA:  Br J Haematol     Country:  England    
Other Details:
Languages:  eng     Pagination:  447-59     Citation Subset:  IM    
Copyright Information:
© 2010 Blackwell Publishing Ltd.
Affiliation:
Department of Paediatrics, Aarhus University Hospital Skejby, Aarhus, Denmark. lene.molgaard@dadlnet.dk
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Age Distribution
Antineoplastic Combined Chemotherapy Protocols / adverse effects*,  therapeutic use
Child
Child, Preschool
Epidemiologic Methods
Finland / epidemiology
Heart Failure / chemically induced,  mortality
Humans
Iceland / epidemiology
Infant
Leukemia, Myeloid, Acute / drug therapy,  mortality*
Opportunistic Infections / mortality
Scandinavia / epidemiology
Sex Distribution
Time Factors
Investigator
Investigator/Affiliation:
S Rosthøj / ; E Oestergaard / ; N Clausen / ; H Hasle / ; H Schroeder / ; M Schmiegelow / ; M Yssing / ; C Rechnitzer / ; B Lausen / ; N Carlsen / ; M Hejl / ; L Hovi / ; M A Siimes / ; K Vettenranta / ; U Pihkala / ; M Perkkiö / ; P Riikonen / ; A Mäkipernaa / ; M Arrola / ; K Parto / ; T Salmi / ; M Lanning / ; M Möttönen / ; G Jónmundsson / ; J Kristinsson / ; S Lie / ; A Glomstein / ; B Zeller / ; H Glosli / ; M Hellebostad / ; J Helgestad / ; B Moström / ; S Kolmannskog / ; R Nygaard / ; T Stockland / ; T Flaegstad / ; L Mellander / ; J Abrahamsson / ; M Behrendtz / ; J Heldrup / ; S Garwicz / ; L Hjorth / ; G Gustafsson / ; S Soderhall / ; M Heyman / ; E Forestier / ; K Johansson / ; P Sandström / ; A Kreuger / ; G Lönnerholm / ; B M Frost / ; J Palle /

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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