{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T20:41:04Z","timestamp":1788381664833,"version":"build-2803163510"},"reference-count":34,"publisher":"Wiley","issue":"23","license":[{"start":{"date-parts":[[2022,10,13]],"date-time":"2022-10-13T00:00:00Z","timestamp":1665619200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Infections cause significant treatment\u2010related morbidity during pediatric acute lymphoblastic leukemia\/lymphoma (ALL\/LLy) therapy. Fevers during periods without severe neutropenia are common, but etiologies are not well\u2010described. This study sought to describe the bloodstream infection (BSI) and non\u2010BSI risk in children undergoing therapy for ALL\/LLy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Demographic and clinical data were abstracted for febrile episodes without severe neutropenia at two children's hospitals. Treatment courses were stratified by intensity. Multivariate logistic regression evaluated characteristics associated with infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 1591 febrile episodes experienced by 524 patients. Of these, 536 (34%) episodes had \u22651 infection; BSI occurred in 30 (1.9%) episodes. No BSIs occurred in episodes with a recent procedural sedation or cytarabine exposure. Presence of hypotension, chills\/rigors, higher temperature, and infant phenotype were independently associated with BSI (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.05). Of the 572 non\u2010BSIs, the most common was upper respiratory infection (URI) (<jats:italic>n<\/jats:italic>\u00a0=\u00a0381, 67%). Compared to episodes without infection, URI symptoms, higher temperature, absolute neutrophil count 500\u2212999\/\u03bcl, and evaluation during a low\u2010intensity treatment course were more likely to be associated with a non\u2010BSI (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.05) and inpatient status was less likely to be associated with a non\u2010BSI (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The BSI rate in pediatric patients with ALL\/LLy and fever without severe neutropenia is low, but one\u2010third of the time, patients have a non\u2010BSI. Future research should test if the need for empiric antibiotics can be tailored based on the associations identified in this study.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.34476","type":"journal-article","created":{"date-parts":[[2022,10,14]],"date-time":"2022-10-14T02:45:46Z","timestamp":1665715546000},"page":"4129-4138","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Infectious events in pediatric patients with acute lymphoblastic leukemia\/lymphoma undergoing evaluation for fever without severe neutropenia"],"prefix":"10.1002","volume":"128","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1689-6214","authenticated-orcid":false,"given":"Pratik A.","family":"Patel","sequence":"first","affiliation":[{"name":"Division of Pediatric Hematology\/Oncology Emory University  Atlanta Georgia USA"},{"name":"Aflac Cancer and Blood Disorders Center Children's Healthcare of Atlanta  Atlanta Georgia 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