Infections during induction therapy of childhood acute lymphoblastic leukemia – no association to mannose‐binding lectin deficiency

  Objectives:  Infection during the induction phase of childhood acute lymphoblastic leukemia (ALL) is a major cause of morbidity and mortality. Several studies have indicated that genetically determined low serum levels of mannose‐binding lectin (MBL), a component of innate immunity, are associated with increased risk for infections in patients receiving chemotherapy. Thus, these patients have been proposed to be candidates for MBL replacement therapy. Methods:  In a population‐based cohort of 137 children with ALL treated at a single pediatric hematology‐oncology center with an almost identical chemotherapy regimen, we studied the relationship between polymorphisms in the MBL gene ( MBL2 ) and the MBL2 promoter and the risk of infections during the first 50 d of induction therapy. Results : No increased frequency of infection was seen for the children with genotypes encoding serum low levels of MBL. A higher incidence of fever ( P  < 0.004), infectious events ( P  = 0.025), days with neutropenia ( P  < 0.001) and a higher frequency of antimicrobial therapy ( P  = 0.0007) were seen in the young age group (<2.5 yr) compared with the older age group (≥2.5 yr), independent of the MBL genotype. Conclusions:  MBL deficiency did not influence the frequency of infections in children receiving induction chemotherapy for ALL, not even in the youngest children (<2.5 yr) whom we found to have the highest risk for infections.