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Ara-C fever and inf...
Ara-C fever and infections after high-dose ara-C treatment in pediatric lymphoid malignancies
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- Ek, Torben, 1963 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för kvinnors och barns hälsa, Avdelningen för pediatrik,Institute for the Health of Women and Children, Dept of Paediatrics
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- Pinkava, M. (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för kvinnors och barns hälsa, Avdelningen för pediatrik,Institute for the Health of Women and Children, Dept of Paediatrics
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- Abrahamsson, Jonas, 1954 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för kvinnors och barns hälsa, Avdelningen för pediatrik,Institute for the Health of Women and Children, Dept of Paediatrics
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(creator_code:org_t)
- 2005
- 2005
- Engelska.
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Ingår i: J Pediatr Hematol Oncol. - 1077-4114. ; 27:7, s. 364-9
- Relaterad länk:
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https://gup.ub.gu.se...
Abstract
Ämnesord
Stäng
- The objective of this study was to examine the incidence and characteristics of Ara-C-related fever and the frequency and severity of infections after single-drug, high-dose Ara-C treatment (HDAC) in children treated for acute lymphoblastic leukemia (ALL) or non-Hodgkin lymphoma (NHL). A retrospective review was performed of 169 courses of HDAC administered to 57 patients (age 1.8-17.8 years). Procalcitonin values (PCT) were analyzed in a subgroup of 16 patients. Fever during HDAC occurred in 113 of 169 (67%) cases. C-reactive protein (CRP) was elevated in the febrile patients (median 38 mg/L [range 3-150]). PCT was elevated (>0.5 ng/mL) during HDAC in 4 of the 16 evaluated patients. Corticosteroids could inhibit fever (P < 0.001). Myelosuppression after HDAC was prominent: 99% developed neutropenia (<0.5 x 10/L) and 92% thrombocytopenia (<25 x 10/L). An early lymphopenia (median 0.1 x 10/L [range 0.01-0.68]) was seen during the first week. G-CSF was used after 12 of the 169 HDAC courses. A febrile episode occurred after 93 of the 169 (55%) HDAC courses, with no need for intensive care and no deaths. The incidence of viridans streptococcal septicemia was 2 of the 169 cases. Ara-C fever is common, and evaluation with inflammation markers is complicated by the fact that HDAC can induce a moderate release of both CRP and PCT. Profound neutropenia and lymphopenia are causative factors for the high incidence of infections, but the risk of life-threatening complications after HDAC in children in remission of lymphoid malignancies is low, even without prophylactic use of colony-stimulating factors.
Nyckelord
- Adolescent
- Antimetabolites
- Antineoplastic/*adverse effects
- Biological Markers/blood
- C-Reactive Protein/analysis
- Child
- Child
- Preschool
- Cytarabine/*adverse effects
- Fever/chemically induced
- Humans
- Infant
- Infection/*epidemiology
- Leukemia
- Lymphocytic
- Acute/drug therapy
- Leukocyte Count
- Lymphoma
- Non-Hodgkin/*drug therapy
- Platelet Count
- Retrospective Studies
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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