Clinical Epidemiology of bacteremia and cardiac dysfunction during AML treatment
Mentor: Dr. Kelly Getz
Leukemia is the most prevalent type of cancer among children, with acute myeloid leukemia (AML) being the second most common type of leukemia and the most life-threatening form of leukemia. Treatment primarily involves multiple rounds of intensive chemotherapy that induces neutropenia, a state in which the white blood cell concentration is low. Consequently, the immune system is severely compromised for weeks after treatment. During neutropenia, children are especially susceptible to infections that can negatively impact treatment progression and survival outcome. While physicians vary in the decision to keep their pediatric patients within the hospital or at home, there are limited data on the effect of in-patient versus out-patient recovery on infectious outcomes and quality of life outcome. The same treatments that are responsible for improvements in AML rates of cure are associated with significant cardiac toxicity. Published data evaluating the occurrence cardiotoxicity and cardio-protective agents during AML treatment generally have not included AML patients. During my summer research experience, I will provide research support on two of Dr. Getz’s ongoing studies. The first project is aimed at describing the trajectory of progression and potential resolution of treatment-related cardiac dysfunction and the patient demographic and clinical factors that predictor those trends. The second study is aimed at comparing clinical outcomes, including the occurrence of infection and treatment delays, as well as patient quality of life for at-home relative to inpatient management of neutropenia after chemotherapy for pediatric AML.