Severe infections in childhood leukemia. A follow-up study of 100 consecutive ALL patients.

Severe infections during the course of childhood ALL were surveyed as a whole in 100 consecutive patients, followed up for 2-8.5 years from the ALL diagnosis. The most important findings were a total absence of disseminated candidiasis, a relative infrequency of gram-negative septicemia (8 episodes), and a predominance of gram-positive cocci (29 episodes) in the 48 verified septicemias. S. aureus was responsible for 50% of culture-positive septicemias. The gram-positive predominance depended probably on local factors, and reservation in using broad-spectrum antibiotics might have played a part. There were 9 cases of disseminated Varicella-zoster, cured successfully with antiviral agents. Pneumocystis carinii pneumonitis numbered 8 episodes, concentrated to the early remission period. One case of miliary tuberculosis was found. Risk factors regarding age of patient and phase or intensity of cytotoxic therapy are evaluated.