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dc.contributor.authorMolgaard-Hansen, Lene
dc.contributor.authorMöttönen, Merja
dc.contributor.authorGlosli, Heidi
dc.contributor.authorJonmundsson, Gudmundur K
dc.contributor.authorAbrahamsson, Jonas
dc.contributor.authorHasle, Henrik
dc.date.accessioned2011-01-10T11:13:02Z
dc.date.available2011-01-10T11:13:02Z
dc.date.issued2010-12
dc.date.submitted2011-01-10
dc.identifier.citationBr. J. Haematol. 2010, 151(5):447-59en
dc.identifier.issn1365-2141
dc.identifier.pmid20955398
dc.identifier.doi10.1111/j.1365-2141.2010.08389.x
dc.identifier.urihttp://hdl.handle.net/2336/119047
dc.descriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links fielden
dc.description.abstractDespite 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.
dc.language.isoenen
dc.publisherWiley-Blackwellen
dc.relation.urlhttp://dx.doi.org/10.1111/j.1365-2141.2010.08389.xen
dc.subject.meshAdolescenten
dc.subject.meshAge Distributionen
dc.subject.meshAntineoplastic Combined Chemotherapy Protocolsen
dc.subject.meshChilden
dc.subject.meshChild, Preschoolen
dc.subject.meshEpidemiologic Methodsen
dc.subject.meshFinlanden
dc.subject.meshHeart Failureen
dc.subject.meshHumansen
dc.subject.meshIcelanden
dc.subject.meshInfanten
dc.subject.meshLeukemia, Myeloid, Acuteen
dc.subject.meshOpportunistic Infectionsen
dc.subject.meshScandinaviaen
dc.subject.meshSex Distributionen
dc.subject.meshTime Factorsen
dc.titleEarly and treatment-related deaths in childhood acute myeloid leukaemia in the Nordic countries: 1984-2003en
dc.typeArticleen
dc.contributor.departmentDepartment of Paediatrics, Aarhus University Hospital Skejby, Aarhus, Denmark. lene.molgaard@dadlnet.dken
dc.identifier.journalBritish journal of haematologyen
html.description.abstractDespite 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.


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