RESPIRATORY INFECTIONES AT CHILDREN WITH ALL TREATED
BY BFM-90 TREATMENT
A. Jancevska, S. Glamocanin, O. Muratovska, K. Martinova, Z. Antevska,
V. Jovanovska, *N. Panovski
Department of Hematology-Oncology, University Children's Hospital,
Skopje, Republic of Macedonia
*Microbyology Institute, Medical Faculty, Skopje, Republic of
Macedonia
Study
includes 46 children (26 boys and 20 girls) with Acute Lymphatic leucosis
(ALL) treated by BFM-90 treatment in Hematology-Oncology Department of
University Children's Hospital in a period 1998-2001 year. BFM-treatment is
uniform or "standard" treatment regimen for cildren with ALL and
consist four main tretment elements: remission induction (Protocol I), CNS
preventive therapy (Protocol M), consolidation (Protocol II) and maintence
therapy.
Most
common complication in this treatment are respiratory infections (RI). In
our study from 46 children, 26 of them (56,5%) had respiratory infections.
Analized on each part of treatment we found : in Protocol-I 17 (65,3%)
children had RI, in Protocol-M 3 (11,5%), in Protocol-II 13 (50%) children
and in Maintence therapy only 5 kids. RI were proved by microbyologycal
investigatons on materials taken of nose and throat and most frequent
microorganizms are Streptococcus pneumoniae in 95% of semples, Hemophillus
influenzae in 3% and Branchamella catharalis in 2%. Very rare bacterias
were Klebsiella, Staphylococcus aureus and Streptoccocus pyogenes. Also we
found that 86,3% of RI were asossiated with neutropenia. RI were treated
with intravenous or intramuscular antibyotherapy (AB Th) by antibyogram and
with various duration. In Protocol-I average 14,9 days, in Protocol-M 15
days, in Protocol-II 18,5 days and Maintence therapy 10,6 days.
At the
end of AB therapy 10 (40,1%) children were current, 14 (59,9%) were
assosiated with other complications, but none of them died.