Children with acute lymphoblastic leukaemia (ALL) can reduce their risk of serious bacterial infections by 60 per cent during the critical first month with the use of prophylactic antibiotics, according to a new study.

ALL is the most common childhood cancer, said the investigators from Dana-Farber/Boston Children's Cancer and Blood Disorders Center. Despite having a high overall cure rate, the disease triggers death in one to two per cent of children during the first month of therapy from treatment complications, primarily infection-related.

Children with ALL are vulnerable to infection by a variety of bacteria, brought about by the disease and the chemotherapy treatment, according to the team. The risk of infection is particularly high during the first or "induction" phase of ALL treatment, they say, when oncologists attempt to push the leukaemia into remission.

“Children who develop bacterial infections during induction can become severely ill and often need to be admitted to the intensive care unit,” said study senior investigator Dr Lewis Silverman, clinical director of the Hematologic Malignancies Center at Dana-Farber/Boston Children's.

The study, Silverman said, sought to find out whether uniform guidelines for antibiotic prophylaxis and fever management could prevent infection-related morbidity and mortality in patients.

For their research, the team involved 229 newly diagnosed children with ALL between 2012 and 2015, who received antibiotics through the entirety of their induction phase of treatment, whether or not they developed a fever. They added universal antibiotic prophylaxis to its 11-001 treatment protocol for pediatric ALL.

The infection rates of patients who received protocol 11-001 were compared with those treated under the 05-001 ALL treatment protocol. For the latter, antibiotics are administered only in response to fever and did not specify the duration of antibiotic treatment.

After the experiment, the researchers found that the incidence of infection risk among those under the prophylactic strategy was approximately 60 per cent lower than that among children on protocol 05-001.

The team noted, however, that they did not find any significant differences in the rates of other treatment-related mortality, fungal infection or Clostridum difficile infection between the two protocols.

“While larger, randomized clinical trials are needed to confirm these findings, these are very exciting results,” Silverman says.

Over 300 Australians are diagnosed with ALL, according to Leukaemia Foundation. While it can occur at any age, ALL is more common in children from 0 to 14 years old, representing nearly 60 per cent of all cases.

Since the disease progresses quickly, treatment needs to begin soon after ALL is diagnosed. Chemotherapy is the main form of treatment for ALL. A combination of drugs, including steroids, is usually given in several cycles with a rest period of a few weeks in between.

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