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dc.contributor.authorLøhmann, Ditte J. A.
dc.contributor.authorAsdahl, Peter H.
dc.contributor.authorAbrahamsson, Jonas
dc.contributor.authorHa, Shau-Yin
dc.contributor.authorJónsson, Ólafur G.
dc.contributor.authorKaspers, Gertjan J. L.
dc.contributor.authorKoskenvuo, Minna
dc.contributor.authorLausen, Birgitte
dc.contributor.authorDe Moerloose, Barbara
dc.contributor.authorPalle, Josefine
dc.contributor.authorZeller, Bernward
dc.contributor.authorHasle, Henrik
dc.date.accessioned2018-08-20T15:34:22Z
dc.date.available2018-08-20T15:34:22Z
dc.date.issued2018-09
dc.date.submitted2018
dc.identifier.citationAssociations between neutrophil recovery time, infections and relapse in pediatric acute myeloid leukemia 2018, 65 (9):e27231 Pediatric Blood & Canceren
dc.identifier.issn15455009
dc.identifier.doi10.1002/pbc.27231
dc.identifier.urihttp://hdl.handle.net/2336/620669
dc.descriptionTo access publisher's full text version of this article click on the hyperlink belowen
dc.description.abstractBACKGROUND: Children with acute myeloid leukemia (AML) treated similarly show different toxicity and leukemic responses. We investigated associations between neutrophil recovery time after the first induction course, infection and relapse in children treated according to NOPHO-AML 2004 and DB AML-01. PROCEDURE: Newly diagnosed patients with AML with bone marrow blast <5% between day 15 after the start of the treatment and the start of second induction course, and in complete remission after the second induction course were included (n = 279). Neutrophil recovery time was defined as the time from the start of the course to the last day with absolute neutrophil count <0.5 × 109 /l. Linear and Cox regressions were used to investigate associations. RESULTS: Neutrophil recovery time after the first induction course was positively associated with neutrophil recovery time after the remaining courses, and longer neutrophil recovery time (≥25 days) was associated with increased risk of grade 3-4 infections (hazard ratio 1.4, 95% confidence interval [CI], 1.1-1.8). Longer neutrophil recovery time after the first induction (>30 days) was associated with the increased risk of relapse (5-year cumulative incidence: 48% vs. 42%, hazard ratio 1.7, 95% CI, 1.1-2.6) for cases not treated with hematopoietic stem cell transplantation in first complete remission. CONCLUSION: Longer neutrophil recovery time after the first induction course was associated with grade 3-4 infections and relapse. If confirmed, this knowledge could be incorporated into risk stratification strategies in pediatric AML.
dc.description.sponsorshipDanish Childhood Cancer Foundation Danish Cancer Society Novo Nordisk Foundationen
dc.language.isoenen
dc.publisherWileyen
dc.relation.urlhttp://doi.wiley.com/10.1002/pbc.27231en
dc.rightsArchived with thanks to Pediatric Blood & Canceren
dc.subjectBráðahvítblæðien
dc.subjectBörnen
dc.subjectBatahorfuren
dc.subject.meshLeukemia, Myeloid, Acuteen
dc.subject.meshNeutropeniaen
dc.subject.meshChilden
dc.subject.meshInfectionen
dc.subject.otheren
dc.titleAssociations between neutrophil recovery time, infections and relapse in pediatric acute myeloid leukemiaen
dc.typeArticleen
dc.contributor.department[ 1 ] Aarhus Univ Hosp, Dept Pediat & Adolescent Med, Palle Juul Jensens Blvd 99, DK-8200 Aarhus N, Denmark Show more [ 2 ] Aarhus Univ Hosp, Dept Hematol, Aarhus, Denmark [ 3 ] Queen Silvia Childrens Hosp, Inst Clin Sci, Dept Pediat, Gothenburg, Sweden Show more [ 4 ] Queen Mary Hosp, Dept Pediat, Hong Kong, Hong Kong, Peoples R China [ 5 ] HKPHOSG, Hong Kong, Hong Kong, Peoples R China Show more [ 6 ] Landspitali Univ Hosp, Dept Pediat, Reykjavik, Iceland [ 7 ] VU Univ Med Ctr Amsterdam, Dept Pediat, The Hague, Netherlands Show more [ 8 ] Dutch Childhood Oncol Grp, The Hague, Netherlands Show more [ 9 ] Univ Helsinki, Div Hematol Oncol & Stem Cell Transplantat, Childrens Hosp, Helsinki, Finland Show more [ 10 ] Univ Copenhagen, Dept Pediat & Adolescent Med, Rigshosp, Copenhagen, Denmark Show more [ 11 ] Ghent Univ Hosp, Dept Pediat, Ghent, Belgium Show more [ 12 ] Uppsala Univ, Dept Womans & Childrens Hlth, Uppsala, Sweden Show more [ 13 ] Oslo Univ Hosp, Div Pediat & Adolescent Med, Oslo, Norwayen
dc.identifier.journalPediatric Blood & Canceren
dc.rights.accessLandspitali Access - LSH-aðganguren
dc.contributor.institutionDepartment of Pediatrics and Adolescent Medicine; Aarhus University Hospital; Aarhus Denmark
dc.contributor.institutionDepartment of Hematology; Aarhus University Hospital; Aarhus Denmark
dc.contributor.institutionInstitution for Clinical Sciences; Department of Pediatrics; Queen Silvia Children's Hospital; Gothenburg Sweden
dc.contributor.institutionDepartment of Pediatrics; Queen Mary Hospital and Hong Kong Pediatric Hematology and Oncology Study Group (HKPHOSG); Hong Kong China
dc.contributor.institutionDepartment of Pediatrics; Landspitali University Hospital; Reykjavik Iceland
dc.contributor.institutionDepartment of Pediatrics; VU University Medical Center Amsterdam, and Dutch Childhood Oncology Group; The Hague The Netherlands
dc.contributor.institutionDivision of Hematology-Oncology and Stem Cell Transplantation; Children's Hospital; University of Helsinki; Helsinki Finland
dc.contributor.institutionDepartment of Pediatrics and Adolescent Medicine; Rigshospitalet; University of Copenhagen; Copenhagen Denmark
dc.contributor.institutionDepartment of Pediatrics; Ghent University Hospital; Ghent Belgium
dc.contributor.institutionDepartment of Woman´s and Children´s Health; Uppsala University; Uppsala Sweden
dc.contributor.institutionDivision of Pediatric and Adolescent Medicine; Oslo University Hospital; Oslo Norway
dc.contributor.institutionDepartment of Pediatrics and Adolescent Medicine; Aarhus University Hospital; Aarhus Denmark
dc.departmentcodePED12
html.description.abstractBACKGROUND: Children with acute myeloid leukemia (AML) treated similarly show different toxicity and leukemic responses. We investigated associations between neutrophil recovery time after the first induction course, infection and relapse in children treated according to NOPHO-AML 2004 and DB AML-01. PROCEDURE: Newly diagnosed patients with AML with bone marrow blast <5% between day 15 after the start of the treatment and the start of second induction course, and in complete remission after the second induction course were included (n = 279). Neutrophil recovery time was defined as the time from the start of the course to the last day with absolute neutrophil count <0.5 × 109 /l. Linear and Cox regressions were used to investigate associations. RESULTS: Neutrophil recovery time after the first induction course was positively associated with neutrophil recovery time after the remaining courses, and longer neutrophil recovery time (≥25 days) was associated with increased risk of grade 3-4 infections (hazard ratio 1.4, 95% confidence interval [CI], 1.1-1.8). Longer neutrophil recovery time after the first induction (>30 days) was associated with the increased risk of relapse (5-year cumulative incidence: 48% vs. 42%, hazard ratio 1.7, 95% CI, 1.1-2.6) for cases not treated with hematopoietic stem cell transplantation in first complete remission. CONCLUSION: Longer neutrophil recovery time after the first induction course was associated with grade 3-4 infections and relapse. If confirmed, this knowledge could be incorporated into risk stratification strategies in pediatric AML.


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