Early and treatment-related deaths in childhood acute myeloid leukaemia in the Nordic countries: 1984-2003.

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.

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Cancer och onkologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cancer and Oncology hsv//eng
SAMHÄLLSVETENSKAP Annan samhällsvetenskap Övrig annan samhällsvetenskap hsv//swe
SOCIAL SCIENCES Other Social Sciences Other Social Sciences not elsewhere specified hsv//eng
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

Möttönen, Merja (författare)
Glosli, Heidi (författare)
Jónmundsson, Guðmundur K (författare)
Abrahamsson, Jonas,1954Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för pediatrik,Institute of Clinical Sciences, Department of Pediatrics(Swepub:gu)xabrjo (författare)
Hasle, Henrik (författare)
Mellander, Lotta,1941Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för pediatrik,Institute of Clinical Sciences, Department of Pediatrics(Swepub:gu)xmello (författare)
Göteborgs universitetInstitutionen för kliniska vetenskaper, Avdelningen för pediatrik (creator_code:org_t)

Av författaren/redakt...: Molgaard-Hansen, ...; Möttönen, Merja; Glosli, Heidi; Jónmundsson, Guð ...; Abrahamsson, Jon ...; Hasle, Henrik; visa fler...; Mellander, Lotta ...; visa färre...

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