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• W2225854154 abstract "18011 Background: Infections are a major cause of morbidity and mortality in AML patients during induction therapy. Prompt antibiotic therapy based on clinical condition and local microbiological susceptibility pattern is vital to their survival. Methods: Retrospective analysis of 100 patients with AML undergoing induction chemotherapy between Jan 2003 and December 2007 was done. Prophylactic antibiotics, anti-fungals or hematopoietic growth factors were not used. Results: The median age was 25 years (range, 1–64) with 56 males and 44 females. Forty one patients (41%) had grade 3 or 4 neutropenia at presentation of which 18 patients (44%) had evidence of infection. 210 episodes of febrile neutropenia were documented with a mean of 2 episodes (range, 1–5) per patient. Clinically, a focus of sepsis was documented in 91 episodes (44%). Twenty patients (20%) had central venous lines. Lung was the most common focus (27%), followed by gastrointestinal tract (14%), skin and subcutaneous tissue (7%), line-related (4%) and 2% each for ear, throat and gums. Blood and sputum cultures were positive in 35 (17%) and 3 (2%) episodes respectively. Of the positive cultures, 92% grew bacteria and 8% fungus. E.coli was the most common isolate (34%), followed by Pseudomonas (21%), Staphylococcus (16%), polymicrobial (16%), Candida in 10%, 5% each of Enterobacter, Enterococcus and Acinetobacter, 2% of Aspergillus, Klebsiella & Streptococcus. 80% responded to initial empiric antibiotic therapy. 60% of all patients had a second spike of fever. Second line antibiotics and antifungals were started in 50% each. 67% responded to second line antibiotics while 57% to antifungal. 11 patients (11%) died during induction therapy, of which 9% were infection related. Conclusions: Culture positive infections are not common in febrile neutropenia during induction therapy of AML. Gram-negative bacteria are the predominant pathogens. This may be due to infrequent use of central lines and absence of prophylactic antibiotic use. In spite of initial response, breakthrough infections are common. Most induction deaths are infection related. No significant financial relationships to disclose." @default.
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• W2225854154 date "2008-05-20" @default.
• W2225854154 modified "2023-09-27" @default.
• W2225854154 title "Analysis of 210 febrile neutropenic episodes during induction therapy of acute myeloid leukemia (AML): An institutional experience from a developing country" @default.
• W2225854154 doi "https://doi.org/10.1200/jco.2008.26.15_suppl.18011" @default.
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