Lack of Effectiveness of Neutropenic Diet and Social Restrictions as Anti-Infective Measures in Children With Acute Myeloid Leukemia: An Analysis of the AML-BFM 2004 Trial
| Autor: | Lars Tramsen, Dirk Reinhardt, Thomas Klingebiel, Emilia Salzmann-Manrique, Ursula Creutzig, Konrad Bochennek, Lillian Sung, Thomas Lehrnbecher |
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| Rok vydání: | 2016 |
| Předmět: |
Male
Cancer Research medicine.medical_specialty Neutropenia Adolescent Medizin Bacteremia Fever of Unknown Origin 03 medical and health sciences symbols.namesake 0302 clinical medicine Risk Factors Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Animals Humans Poisson regression Poisson Distribution Antibiotic prophylaxis Fever of unknown origin Intensive care medicine Child Infection Control business.industry Incidence (epidemiology) Infant Newborn Myeloid leukemia Infant Pets Pneumonia ORIGINAL REPORTS Antibiotic Prophylaxis medicine.disease Social Participation Anti-Bacterial Agents Diet Gastroenteritis Clinical trial Leukemia Myeloid Acute Oncology 030220 oncology & carcinogenesis Child Preschool symbols Female business 030215 immunology |
| Zdroj: | Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 34(23) |
| ISSN: | 1527-7755 |
| Popis: | Purpose Although nonpharmacologic anti-infective measures are widely used in children treated for acute myeloid leukemia (AML), there is little evidence of their effectiveness. Patients and Methods We analyzed infectious complications in children during intensive treatment of AML according to the AML-BFM 2004 trial and surveyed sites on institutional standards regarding recommended restrictions of social contacts (six items), pets (five items), and food (eight items). A scoring system was developed with a restriction score for each item. Multivariable Poisson regression adjusted for sex, age, weight group, risk stratification, and prophylactic antibiotics was used to estimate the impact of the restrictions on the incidence ratios of fever of unknown origin, bacteremia, pneumonia, and gastroenteritis. Results Data on recommendations of nonpharmacologic anti-infective measures and infectious complications were available in 339 patients treated in 37 institutions. Analyses did not demonstrate a significant benefit of any of the restrictions regarding food, social contacts, and pets on the risk of fever, bacteremia, pneumonia, and gastroenteritis. In contrast, age, weight group, risk stratification, and nonabsorbable antibiotics had some influence on infections complications. Conclusion The lack of effectiveness of dietary restrictions and restrictions regarding social contacts and pets should result in reconsideration of anti-infective policies. |
| Databáze: | OpenAIRE |
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