title: [Characterization of episodes of febrile neutropenia in children with acute myeloid leukemia and acute lymphoblastic leukemia].
abstract: BACKGROUND
  Leukemia is the most common cancer in Chilean children. Acute lymphoblastic leukemia (ALL) is more prevalent and longer survival compared to acute myeloid leukemia (AML).
  
  
  OBJECTIVE
  To describe episodes of febrile neutropenia (FN) in children with AML, determining frequency of infections as agent, focus and evolution, comparing children with ALL episodes.
  
  
  METHODS
  A prospective multicenter study. Children presenting with FN at six hospitals in Santiago, Chile, were invited to participate in two consecutive FONDECYT projects, from April 2004 to June 2011. All patients were uniformly evaluated, recording epidemiological, clinical and laboratory variables. Information regarding FN episodes of children with LMA and LLA was used to this study.
  
  
  RESULTS
  We evaluated 506 episodes of FN in children with leukemia: 173 children with AML and 333 in children with ALL. NF episodes in children with ALML showed significantly greater depth and duration of neutropenia, febrile remained a > period of time and had a worse clinical outcome, as evidenced by > hemodynamic instability, > sepsis, CRP > 90 mg/L for a longer time, more days of hospitalization, > frequency of hospitalization in ICU, > bacteremia, mainly by Streptococcus viridans group, > change of antimicrobial treatment, > use of antifungal therapy.
  
  
  CONCLUSIONS
  This study demonstrates that FN episodes in children with ALML further evolve unfavorably, compared with episodes of FN in children with ALL. FN episodes in children with ALML require a more aggressive diagnostic and therapeutic approach, related to its severity.
authors.forename: Karen
authors.initials: K
authors.lastname: Ducasse
authors.forename: José P
authors.initials: JP
authors.lastname: Fernández
authors.forename: Carmen
authors.initials: C
authors.lastname: Salgado
authors.forename: Ana M
authors.initials: AM
authors.lastname: Alvarez
authors.forename: Carmen L
authors.initials: CL
authors.lastname: Avilés
authors.forename: Ana
authors.initials: A
authors.lastname: Becker
authors.forename: Santiago
authors.initials: S
authors.lastname: Topelberg
authors.forename: Juan
authors.initials: J
authors.lastname: Tordecilla
authors.forename: Mónica
authors.initials: M
authors.lastname: Varas
authors.forename: Milena
authors.initials: M
authors.lastname: Villarroel
authors.forename: Tamara
authors.initials: T
authors.lastname: Viviani
authors.forename: Marcela
authors.initials: M
authors.lastname: Zubieta
authors.forename: María E
authors.initials: ME
authors.lastname: Santolaya
mesh_terms: D002648:Child; D064147:Febrile Neutropenia / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000150:complications*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications*; D011446:Prospective Studies; D012720:Severity of Illness Index