title: Variations in non-pharmacological anti-infective measures in childhood leukemia--results of an international survey.
abstract: BACKGROUND
  Standardization in clinical practice may lead to improved outcomes. Unfortunately, little is known about the variability of non-pharmacological anti-infective measures in children with cancer.
  
  
  METHODS
  A web-based survey assessed institutional recommendations regarding restrictions of social contacts, pets and food and instructions on wearing face masks in public for children with standard- risk acute lymphoblastic leukemia and acute myeloid leukemia during intensive chemotherapy.
  
  
  RESULTS
  A total of 336 institutions in 27 countries responded to the survey (range, 1-76 institutions per country; overall response rate 61%). Most institutions recommend that patients with acute myeloid leukemia avoid indoor public places and daycare, kindergarten and school, whereas recommendations for patients with acute lymphoblastic leukemia differ considerably by institution. In terms of restrictions related to pets, there was a wide variability between institutions for both acute lymphoblastic and acute myeloid leukemia patients. Most, but not all institutions do not allow children with either acute lymphoblastic or acute myeloid leukemia to eat raw meat, raw seafood or unpasteurized milk. Whereas most institutions do not routinely recommend that patients with acute lymphoblastic leukemia wear face masks in public, advice on this matter varies for patients with acute myeloid leukemia.
  
  
  CONCLUSIONS
  The survey demonstrates that there is a wide variation in recommendations on non-pharmacological anti-infective measures between different institutions, countries and continents. This information may be used to encourage harmonization of supportive care practices and future clinical trials.
authors.affiliation: University of Frankfurt, Germany. Thomas.Lehrnbecher@kgu.de
authors.forename: Thomas
authors.initials: T
authors.lastname: Lehrnbecher
authors.forename: Richard
authors.initials: R
authors.lastname: Aplenc
authors.forename: Fernanda
authors.initials: F
authors.lastname: Rivas Pereira
authors.forename: Alvaro
authors.initials: A
authors.lastname: Lassaletta
authors.forename: Désirée
authors.initials: D
authors.lastname: Caselli
authors.forename: Jerzy
authors.initials: J
authors.lastname: Kowalczyk
authors.forename: Julia
authors.initials: J
authors.lastname: Chisholm
authors.forename: Lillian
authors.initials: L
authors.lastname: Sung
mesh_terms: D002648:Child; D002675:Child, Preschool; D003141:Communicable Diseases / Q000209:etiology*; D006306:Health Surveys; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000150:complications* / Q000188:drug therapy; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000188:drug therapy; D012307:Risk Factors