{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T16:30:57Z","timestamp":1790872257209,"version":"4.1.0"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2016,1,15]],"date-time":"2016-01-15T00:00:00Z","timestamp":1452816000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2016,1,15]],"date-time":"2016-01-15T00:00:00Z","timestamp":1452816000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Blood Cancer Journal"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Infections are an important cause for morbidity and mortality in pediatric acute myeloid leukemia (AML). We therefore characterized infectious complications in children treated according to the trial AML-BFM 2004. Patients with Down syndrome were excluded from the analysis. Data were gathered from the medical records in the hospital where the patients were treated. A total of 405 patients (203 girls; median age 8.4 years) experienced 1326 infections. Fever without identifiable source occurred in 56.1% of the patients and clinically and microbiologically documented infections in 17.5% and 32.4% of the patients, respectively. In all, 240 Gram-positive (112 viridans group streptococci) and 90 Gram-negative isolates were recovered from the bloodstream. Invasive fungal infection was diagnosed in 3% of the patients. Three children each died of Gram-negative bacteremia and invasive aspergillosis, respectively. As compared with the results of AML-BFM 93 with lower dose intensity, infection-related morbidity was slightly higher in AML-BFM 2004 (3.3. versus 2.8 infections per patient), whereas infection-related mortality significantly decreased (1.5% versus 5.4%;\n                    <jats:italic>P<\/jats:italic>\n                    =0.003). Specific anti-infective recommendations included in the treatment protocol, regular training courses for pediatric hematologists and increasing experience may be the reason for reduced infection-related mortality in children with AML. Further studies are needed to decrease infection-related morbidity.\n                  <\/jats:p>","DOI":"10.1038\/bcj.2015.110","type":"journal-article","created":{"date-parts":[[2016,1,15]],"date-time":"2016-01-15T16:55:18Z","timestamp":1452876918000},"page":"e382-e382","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":76,"title":["Infectious complications in children with acute myeloid leukemia: decreased mortality in multicenter trial AML-BFM 2004"],"prefix":"10.1038","volume":"6","author":[{"given":"K","family":"Bochennek","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Hassler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Perner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Gilfert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Sch\u00f6ning","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T","family":"Klingebiel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D","family":"Reinhardt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"U","family":"Creutzig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T","family":"Lehrnbecher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2016,1,15]]},"reference":[{"key":"BFbcj2015110_CR1","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1038\/sj.leu.2403188","volume":"18","author":"T Lehrnbecher","year":"2004","unstructured":"Lehrnbecher T, Varwig D, Kaiser J, Reinhardt D, Klingebiel T, Creutzig U . Infectious complications in pediatric acute myeloid leukemia: analysis of the prospective multi-institutional clinical trial AML-BFM 93. Leukemia 2004; 18: 72\u201377.","journal-title":"Leukemia"},{"key":"BFbcj2015110_CR2","doi-asserted-by":"publisher","first-page":"3532","DOI":"10.1182\/blood-2007-05-091942","volume":"110","author":"L Sung","year":"2007","unstructured":"Sung L, Lange BJ, Gerbing RB, Alonzo TA, Feusner J . Microbiologically documented infections and infection-related mortality in children with acute myeloid leukemia. Blood 2007; 110: 3532\u20133539.","journal-title":"Blood"},{"key":"BFbcj2015110_CR3","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1097\/00043426-199709000-00001","volume":"19","author":"T Lehrnbecher","year":"1997","unstructured":"Lehrnbecher T, Foster C, Vazquez N, Mackall CL, Chanock SJ . Therapy-induced alterations in host defense in children receiving chemotherapy. J Ped Hematol Oncol 1997; 19: 399\u2013417.","journal-title":"J Ped Hematol Oncol"},{"key":"BFbcj2015110_CR4","doi-asserted-by":"publisher","first-page":"3187","DOI":"10.1182\/blood-2012-03-362608","volume":"120","author":"U Creutzig","year":"2012","unstructured":"Creutzig U, van den Heuvel-Eibrink MM, Gibson B, Dworzak MN, Adachi S, de Bont E et al. Diagnosis and management of acute myeloid leukemia in children and adolescents: recommendations from an international expert panel. Blood 2012; 120: 3187\u20133205.","journal-title":"Blood"},{"key":"BFbcj2015110_CR5","doi-asserted-by":"crossref","first-page":"S79","DOI":"10.4067\/S0716-10182005000500001","volume":"22","author":"ME Santolaya","year":"2005","unstructured":"Santolaya ME, Rabagliati R, Bidart T, Paya E, Guzman AM, Morales R et al. [Consensus: Rational approach towards the patient with cancer, fever and neutropenia]. 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Ann Hematol 2003; 82: S105\u2013S117.","journal-title":"Ann Hematol"},{"key":"BFbcj2015110_CR7","doi-asserted-by":"publisher","first-page":"1143","DOI":"10.1016\/j.bbmt.2009.06.019","volume":"15","author":"M Tomblyn","year":"2009","unstructured":"Tomblyn M, Chiller T, Einsele H, Gress R, Sepkowitz K, Storek J et al. Guidelines for preventing infectious complications among hematopoietic cell transplantation recipients: a global perspective. Biol Blood Marrow Transplant 2009; 15: 1143\u20131238.","journal-title":"Biol Blood Marrow Transplant"},{"key":"BFbcj2015110_CR8","doi-asserted-by":"publisher","first-page":"819","DOI":"10.1586\/17474086.2014.965140","volume":"7","author":"T Lehrnbecher","year":"2014","unstructured":"Lehrnbecher T, Sung L . Anti-infective prophylaxis in pediatric patients with acute myeloid leukemia. 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Incidence of bacteremias and invasive mycoses in children with acute non-lymphoblastic leukemia: results from a multi-center Italian study. Pediatr Blood Cancer 2010; 55: 1103\u20131107.","journal-title":"Pediatr Blood Cancer"},{"key":"BFbcj2015110_CR15","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1097\/INF.0000000000000058","volume":"33","author":"V Lewis","year":"2014","unstructured":"Lewis V, Yanofsky R, Mitchell D, Dix D, Ethier MC, Gillmeister B et al. Predictors and outcomes of viridans group streptococcal infections in pediatric acute myeloid leukemia: from the Canadian infections in AML research group. Pediatr Infect Dis J 2014; 33: 126\u2013129.","journal-title":"Pediatr Infect Dis J"},{"key":"BFbcj2015110_CR16","doi-asserted-by":"publisher","first-page":"e78","DOI":"10.1097\/INF.0000000000000591","volume":"34","author":"S Felsenstein","year":"2015","unstructured":"Felsenstein S, Orgel E, Rushing T, Fu C, Hoffman JA . Clinical and microbiologic outcomes of quinolone prophylaxis in children with acute myeloid leukemia. Pediatr Infect Dis J 2015; 34: e78\u2013e84.","journal-title":"Pediatr Infect Dis J"},{"key":"BFbcj2015110_CR17","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1111\/j.1365-2141.2009.07844.x","volume":"147","author":"T Lehrnbecher","year":"2009","unstructured":"Lehrnbecher T, Ethier MC, Zaoutis T, Creutzig U, Gamis A, Reinhardt D et al. International variations in infection supportive care practices for paediatric patients with acute myeloid leukaemia. Br J Haematol 2009; 147: 125\u2013128.","journal-title":"Br J Haematol"},{"key":"BFbcj2015110_CR18","doi-asserted-by":"publisher","first-page":"e327","DOI":"10.1016\/S1470-2045(14)70017-8","volume":"15","author":"AH Groll","year":"2014","unstructured":"Groll AH, Castagnola E, Cesaro S, Dalle JH, Engelhard D, Hope W et al. 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Treatment-related deaths during induction and first remission of acute myeloid leukaemia in children treated on the Tenth Medical Research Council acute myeloid leukaemia trial (MRC AML10). The MCR Childhood Leukaemia Working Party. Br J Haematol 1999; 106: 436\u2013444.","journal-title":"Br J Haematol"}],"container-title":["Blood Cancer Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/bcj2015110.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/bcj2015110","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/bcj2015110.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,4]],"date-time":"2023-01-04T04:04:30Z","timestamp":1672805070000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/bcj2015110"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,1,15]]},"references-count":20,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2016,1]]}},"alternative-id":["BFbcj2015110"],"URL":"https:\/\/doi.org\/10.1038\/bcj.2015.110","relation":{},"ISSN":["2044-5385"],"issn-type":[{"value":"2044-5385","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,1,15]]},"assertion":[{"value":"2 November 2015","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 November 2015","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 January 2016","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no conflict of interest.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}