Infectious Complications in Children, Adolescents, and Young Adults Treated for Acute Leukemia and Lymphoblastic Lymphoma: A Single-Center Experience

The implementation of pediatric protocols for the treatment of adolescents and young adults (AYA) has led to an improvement in the survival rate of patients with acute leukemia (AL). However, the incidence of complications is higher in this population than in children. The objective of this study is to compare the occurrence of infectious complications during periods of severe neutropenia in children, adolescents, and young adults. This retrospective single-center observational study compares the incidence of infections during severe neutropenia episodes and the management of these between 2 groups (children and AYA) over a 4-year period (2017 to 2021). A total of 54 patients and 243 severe neutropenia episodes were examined, and 63 infections were identified. The incidence of infection was significantly higher in the AYA population (40% vs. 23%, P =0.02), but this difference was linked to a higher frequency of acute myeloid leukemia. However, AYA population presents more catheter-related infections (12% vs. 2%, aOR: 6.4, 95% CI: 1.7-25.1, P <0.01) and infections of the skin and soft tissues (14% vs. 4%, aOR: 3.9, 95% CI: 1.2-12.8, P =0.03) irrespective of the type of leukemia. In conclusion, this study reveals that AYA had more infectious complications than children, particularly more catheter, skin, and soft tissue infections.