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Infections during induction therapy of childhood acute lymphoblastic leukemia – no association to mannose‐binding lectin deficiency
Author(s) -
Lausen Birgitte,
Schmiegelow Kjeld,
Andreassen Bente,
Madsen Hans O.,
Garred Peter
Publication year - 2006
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/j.1600-0609.2006.00632.x
Subject(s) - mannan binding lectin , medicine , immunology , hematology , neutropenia , incidence (geometry) , chemotherapy , acute lymphocytic leukemia , acute leukemia , induction chemotherapy , leukemia , lectin , lymphoblastic leukemia , physics , optics
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.