Infection during induction of remission in acute lymphocytic leukemia

The effects of infectious diseases during the transition from untreated acute lymphocytic leukemia to induction of remission were studied in 100 children enrolled consecutively into a standardized protocol for chemotherapy. During the initial 6 weeks of therapy, 30 patients had no evidence of infection; 19 had episodes of fever without other evidence of infection, and 51 had one or more episodes of infectious diseases. Most of the infections and febrile episodes occurred prior to and during the first week of therapy. Bacterial sepsis or meningitis and systemic candidiasis accounted for the serious infections. The incidence was inversely related to the absolute neutrophil count. Immunoglobulin values were normal. The occurrence of infection during the initial 6 weeks of anticancer therapy had no relation to success or failure of induction and continuation of complete remission of the leukemia.