{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T01:59:51Z","timestamp":1755223191292,"version":"3.43.0"},"reference-count":43,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T00:00:00Z","timestamp":1748217600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Infection causes significant morbidity and mortality in pediatric acute myeloid leukemia (pAML). This study describes the incidence and risk factors of bloodstream infection (BSI) and invasive fungal infection (IFI) in pAML.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective chart review was performed of patients treated according to the ANLL\u201097\/AML\u201012 (<jats:italic>N<\/jats:italic> = 116), AML\u201015 (<jats:italic>N<\/jats:italic> = 60), or DB AML\u201001 (<jats:italic>N<\/jats:italic> = 67) protocols between 1998 and 2014. Cumulative incidence was analyzed for infectious outcomes (any BSI, viridans group streptococci [VGS\u2010BSI], Gram\u2010negative rod [GNR\u2010BSI], IFI). Risk factors were analyzed in multivariable models. Recurrent event analyses were performed to evaluate whether previous infection(s) were related to subsequent infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The cumulative incidence of any BSI was 78%, VGS\u2010BSI 35%, GNR\u2010BSI 15%, and IFI 11% through Day 150. Incidence of GNR\u2010BSI decreased over time; AML\u201015 hazard ratio ([HR] 0.37, 95% confidence interval [CI]: 0.14\u20130.98, <jats:italic>p<\/jats:italic> = 0.045) and DB AML\u201001 (HR 0.42, 95% CI: 0.18\u20130.97, <jats:italic>p<\/jats:italic> = 0.042) compared to ANLL\u201097\/AML\u201012. White blood cell counts \u226520\u00a0\u00d7\u00a010<jats:sup>9<\/jats:sup>\/L at diagnosis and older age were associated with lower infection risk. Recurrent event analyses showed a higher risk of subsequent BSI for patients who had two or more prior BSIs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Despite efforts to improve supportive care in pAML, only GNR\u2010BSI cumulative incidence declined over time. Future studies should continue working toward decreasing the incidence of infection\u00a0while maintaining treatment efficacy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.31819","type":"journal-article","created":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T00:49:34Z","timestamp":1748306974000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Infectious Morbidity During Pediatric Acute Myeloid Leukemia Chemotherapy in a High\u2010Income Country: A 15\u2010Year Population\u2010Based Overview"],"prefix":"10.1002","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5217-5983","authenticated-orcid":false,"given":"Emily R.","family":"Schwartz","sequence":"first","affiliation":[{"name":"Pediatric Oncology Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam Cancer Center Amsterdam  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kim","family":"Klein","sequence":"additional","affiliation":[{"name":"Pediatric Oncology Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam Cancer Center Amsterdam  Amsterdam The Netherlands"},{"name":"University Medical Center Utrecht\/Wilhelmina Children's Hospital  Utrecht The Netherlands"},{"name":"Princess M\u00e1xima Center for Pediatric Oncology  Utrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Birgit I.","family":"Lissenberg\u2010Witte","sequence":"additional","affiliation":[{"name":"Epidemiology and Data Science Amsterdam UMC Vrije Universiteit Amsterdam  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tom F. W.","family":"Wolfs","sequence":"additional","affiliation":[{"name":"University Medical Center Utrecht\/Wilhelmina Children's Hospital  Utrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0339-6816","authenticated-orcid":false,"given":"Val\u00e9rie","family":"de Haas","sequence":"additional","affiliation":[{"name":"Pediatric Oncology Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam Cancer Center Amsterdam  Amsterdam The Netherlands"},{"name":"Princess M\u00e1xima Center for Pediatric Oncology  Utrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bianca","family":"Goemans","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology  Utrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natasja","family":"Dors","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology  Utrecht The Netherlands"},{"name":"Radboud University Medical Center  Nijmegen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marry M.","family":"van den Heuvel\u2010Eibrink","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology  Utrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rutger R. G.","family":"Knops","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology  Utrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wim J. E.","family":"Tissing","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology  Utrecht The Netherlands"},{"name":"University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Birgitta A.","family":"Versluys","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology  Utrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C. 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