Bacterial infections in pediatric Hodgkin's disease: relationship to radiotherapy, chemotherapy and splenectomy.
The occurrence of bacterial infections (B.I.) among 181 children with Hodgkin's disease (121 with splenectomy, 60 without splenectomy) was analyzed. Twenty-seven B.I. occurred among 22 children and included 15 episodes of bacteremia-meningitis in 14 children. B.I. occurred in all age groups, but bacteremia-meningitis occurred most commonly in splenectomized children 10 years of age or less. The frequency of B.I. in splenectomized children receiving radiotherapy was 1.4%, compared to 18.3% among those receiving chemotherapy (p less than 0.05); the frequency of B.I. among non-splenectomized children receiving radiotherapy was 2.8%, compared to 23.1% among those receiving chemotherapy (p less than 0.05). There was no difference in the probability of B.I. as a function of splenectomy for the corresponding groups, although all cases of Streptococcus pneumoniae and Hemophilus influenzae bacteremia-meningitis in splenectomized children. Overwhelming postsplenectomy bacteremia infection not related to active disease or treatment occurred in 3/121 (2.5%) children, accounting for only one fatality (0.8%).
D000293:Adolescent; D000367:Age Factors; D000380:Agranulocytosis / Q000150:complications; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001424:Bacterial Infections / Q000209:etiology* / Q000517:prevention & control; D002648:Child; D002675:Child, Preschool; D005260:Female; D006192:Haemophilus Infections / Q000209:etiology; D006193:Haemophilus influenzae; D006689:Hodgkin Disease / Q000150:complications* / Q000628:therapy; D006801:Humans; D007223:Infant; D008297:Male; D008581:Meningitis / Q000209:etiology; D011008:Pneumococcal Infections / Q000209:etiology; D018805:Sepsis / Q000209:etiology; D013156:Splenectomy / Q000009:adverse effects*
D000970:Antineoplastic Agents