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Expert Opin Pharmacother. 2020 Feb;21(2):193-205. doi: 10.1080/14656566.2019.1701654. Epub 2020 Jan 8.

Pharmacological prophylaxis of infection in pediatric acute myeloid leukemia patients.

Author information

1
Pediatric Hematology-Oncology Department, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel.
2
Department of Hematology and Bone Marrow Transplantation, Rambam Health Care Campus Haifa, Haifa, Israel.
3
Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel.
4
Department of Hematology, Shaare Zedek Medical Center, Jerusalem, Israel.
5
Pediatric Infectious Diseases Unit, Rambam Health Care Campus, Ruth Rappaport Children's Hospital Haifa, Israel.

Abstract

Introduction: Pediatric patients treated for acute myeloid leukemia (AML) are at high risk of developing severe infectious complications. The choice of an optimum supportive treatment should be based on local epidemiology, as well as intensity and toxicity of the anti-leukemic therapy applied.Areas covered: This review presents an overview of recently published studies focusing on the prevention of infection in pediatric AML patients. PubMed has been systematically searched for clinical trials, reviews, and meta-analyses published in the last 10 years. The focus of this article will be limited to primary prophylaxis only, while secondary prophylaxis is beyond the scope of the current review.Expert opinion: Although anti-bacterial agents may decrease the bacterial infection burden, there is no consensus regarding prophylactic use. To that end, there is a need for further randomized controlled trials to establish the precise role of anti-bacterial prophylaxis in pediatric AML patients. The prophylactic use of anti-fungal agents is strongly recommended for all AML patients. Since the contribution of hematopoietic growth factors to improved survival has not been demonstrated, they should not be routinely applied. Decisions regarding an appropriate prophylactic strategy should be taken in collaboration with the infectious disease experts and pharmacology team.

KEYWORDS:

Acute myeloid leukemia; children; infection; prophylaxis

PMID:
31914337
DOI:
10.1080/14656566.2019.1701654
[Indexed for MEDLINE]

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