title: Correlation of serum immunoglobulins with infection-related parameters during induction chemotherapy of pediatric acute myeloid leukemia: a prospective study.
abstract: BACKGROUND
  Immune dysfunction may be a contributing factor for infections during induction chemotherapy of pediatric acute myeloid leukemia (AML); but this has not been evaluated as yet.
  
  
  METHODS
  From April 2010 to May 2011, 45 consecutive de novo pediatric AML patients were prospectively evaluated along with nine healthy controls. Immunoglobulins (Ig) (n = 45) were measured at diagnosis and day 15.
  
  
  RESULTS
  There were 25 male and 20 female patients with a median age of 9 years (range 1-18 years). Baseline Ig did not correlate with any of the infection-related parameters during induction. At day 15, Ig levels reduced from baseline (IgG p = 0.46, IgA p = 0.027, IgM p < 0.001). Day 15 IgG levels were lower in patients with persistent fever >7 days (p = 0.029) and fungal infection (p = 0.035).
  
  
  CONCLUSIONS
  This is the first study which has evaluated derangement in Ig with infection-related parameters in pediatric AML. At day 15, immunoglobulins decrease and reduced IgG levels correlate with infection-related parameters. Use of intravenous immunoglobulins in pediatric AML cases needs to be further evaluated to assess whether it can reduce infection-related morbidity.
authors.affiliation: Department of Medical Oncology, All India Institute of Medical Sciences , New Delhi , India.
authors.forename: Anuj Kumar
authors.initials: AK
authors.lastname: Bansal
authors.forename: Sreenivas
authors.initials: S
authors.lastname: Vishnubhatla
authors.forename: Sameer
authors.initials: S
authors.lastname: Bakhshi
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D060828:Induction Chemotherapy; D007223:Infant; D007239:Infections / Q000097:blood* / Q000209:etiology; D015470:Leukemia, Myeloid, Acute / Q000097:blood* / Q000150:complications / Q000188:drug therapy*; D008297:Male; D011446:Prospective Studies
chemical_list: D007074:Immunoglobulin G
keywords: Immunoglobulin; induction chemotherapy; infection; pediatric acute myeloid leukemia