Pediatric Cancer Patients at High Risk of Bloodstream Infections during Chemotherapy

Strategic Insights -

Pediatric cancer patients, especially those diagnosed with acute myeloid leukemia (AML), are at a significantly higher risk of developing bloodstream infections (BSIs) during chemotherapy, particularly during episodes of febrile neutropenia (FN). According to a recent study published in the JMA Journal, researchers from Shiga University analyzed electronic medical records of 152 pediatric patients with cancer treated between April 2012 and March 2023. The study found that the incidence of BSI was higher in patients with AML compared to other cancer types, with a significantly higher BSI incidence during FN episodes.

Key Takeaways:

  • The study included 152 pediatric patients with cancer who underwent 829 chemotherapy courses, with the majority of patients (21) diagnosed with AML.
  • The AML group exhibited the highest proportion of BSI across all chemotherapy courses (17% vs. 4%-7%).
  • During FN episodes, the AML cohort had a significantly higher BSI incidence (22%) than other groups (7%-13%).
  • Chemotherapy courses involving high-dose cytarabine (HD-CA) had a substantially higher BSI incidence (30%) among the patients with AML compared to courses without HD-CA (2%).
  • Patients with AML have the highest risk of BSIs in pediatric malignancies, particularly during FN episodes.
  • The study highlights an association between BSIs and HD-CA use in patients with AML.

Statistics:

  • 21 patients with AML were included in the cohort.
  • The AML group exhibited a 17% BSI proportion across all chemotherapy courses.
  • During FN episodes, the AML cohort had a 22% BSI incidence.
  • Chemotherapy courses involving HD-CA had a 30% BSI incidence among patients with AML.
  • Courses involving HD-CA without HD-CA had a 2% BSI incidence.

Sources:

  • Incidence of Bloodstream Infections in Pediatric Patients with Cancer during Febrile Neutropenia: A Retrospective Study. JMA Journal, 2025;8(2):560-567.