Pneumonia during therapy for childhood acute lymphoblastic leukemia
S. E. Siegel, M. E. Nesbit, R. Baehner, H. Sather and G. D. Hammond
The incidence of pneumonia was evaluated in 844 children undergoing initial
treatment for acute lymphoblastic leukemia (ALL). A total of 310 episodes
occurred in 239 patients followed up for five to 36 months after diagnosis.
The peak incidences occurred in the periods 0 to 20 days and 40 to 80 days
after the start of antileukemic therapy. Bacterial pneumonias occurred
primarily during the first 20 days after diagnosis of ALL. No episode of
Pneumocystis carinii pneumonia was noted before 40 days, and the majority
of instances occurred 50 to 120 days after diagnosis. In 80% of all
episodes, a specific causative organism was not detected. The incidence of
P carinii pneumonia was greater in patients receiving intrathecal
methotrexate as part of CNS prophylaxis than in those receiving only CNS
irradiation. Pneumonia is a frequent event during the therapy of ALL in
childhood.
