Importance of neutropenia for development of invasive infections at various phases of treatment for hemato-oncological diseases in children

Annelies M. Zwitserloot, Annelies M.C. Mavinkurve-Groothuis, Joep M. Galama, Paul E. Verweij, Peter M. Hoogerbrugge, Adilia Warris

Research output: Contribution to journalReview articlepeer-review

5 Citations (Scopus)


Introduction: Prolonged neutropenia in patients with acute myeloid leukemia (AML), relapsed acute lymphoblastic leukemia (r-ALL), myelodysplastic syndrome (MDS), and those receiving hematopoietic stem cell transplantation (HSCT), is a well-known risk factor for infectious complications. Few data are available about the incidence and etiology of infectious episodes during the total treatment period associated with a decreased immunity. Methods: Between January 2000 and December 2005 children diagnosed with AML, r-ALL, and MDS, and post-HSCT patients were included in the study. A retrospective review based on microbiological data was performed to describe the incidence and etiology of the infectious complications during the total treatment period. Results: One hundred and thirty disease-specific patient episodes were included. Forty-two percent of 184 microbiologically proven infectious episodes were diagnosed in patients receiving chemotherapy, and 58% occurred in HSCT patients. During neutropenia, 123 (67%) infectious episodes were diagnosed; of the isolated species 83% were bacterial, 6% fungal, and 11% viral. In the period without neutropenia, 61 (33%) infectious episodes were diagnosed, with 38% bacterial, 3% fungal, and 59% viral species isolated. Of the infectious episodes diagnosed in patients treated with an HSCT, 52% (n = 55) occurred in the post-engraftment period. In contrast, in patients treated with chemotherapy, 92% of the infectious episodes were diagnosed during neutropenia. Conclusion: The number of proven infectious episodes in post-HSCT patients was not influenced by the presence of neutropenia, while in patients receiving chemotherapy significantly lower numbers of proven infectious episodes were diagnosed outside the neutropenic period.

Original languageEnglish
Pages (from-to)355-362
Number of pages8
JournalScandinavian Journal of Infectious Diseases
Issue number5
Publication statusPublished - May 2012
Externally publishedYes


  • Children
  • Hemato-oncological disorders
  • Infectious complications
  • Neutropenia
  • Post-hematopoietic stem cell transplantation


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