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Prophylaxis reduced risk for chemotherapy-related infection in pediatric ALL, AML
Pediatric patients with acute lymphoblastic leukemia or acute myeloid leukemia who underwent intensive chemotherapy demonstrated fewer occurrences of bloodstream and invasive fungal infections when they received prophylaxis with ciprofloxacin and voriconazole or micafungin, according to study results.
Before prophylaxis, 44 bloodstream infection episodes and 22 invasive fungal infection episodes occurred among 62 children with ALL and 24 children with AML who were undergoing intensive chemotherapy. Severe infection resulted in seven deaths.
Patients received prophylaxis at the onset of neutropenia and continued treatment until absolute neutrophil count recovered to ˃100/mcL
When patients became neutropenic with more than 7 days of neutropenia expected, researchers administered 300 mg/m2 ciprofloxacin every 12 hours.
Patients with AML also received 4 mg/kg voriconazole every 12 hours at the onset of neutropenia, and patients with ALL received the drug after 7 days of neutropenia.
Researchers substituted 2 mg/kg daily micafungin (Mycamine, Astellas) for voriconazole among patients with ALL who received vincristine.
During prophylaxis, there were 10 episodes of bloodstream infection and no cases of invasive fungal infections among 51 patients with ALL and 14 patients with AML.
No patients died of severe infection during prophylaxis.
Researchers also noted significant reductions in febrile neutropenia and ICU stay during prophylaxis.
Disclosure: See the study for a full list of the researchers’ relevant financial disclosures.