ArticleJournal of blood medicine2013
Randomized double blind trial of ciprofloxacin prophylaxis during induction treatment in childhood acute lymphoblastic leukemia in the WK-ALL protocol in Indonesia.
Article in Journal of blood medicine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
16 citing papers in PubMed, 3 syntheses or guidelines pooled it, 33 citations in OpenAlex.
- Efficacy of fluoroquinolone prophylaxis during induction phase in children with acute lymphoblastic leukemia: a systematic review and meta-analysis.European journal of pediatrics · 2026Pooled it
- Recommendations for antibacterial prophylaxis in children receiving chemotherapy: a joint initiative of SITIP and infectious disease group of AIEOP.Italian journal of pediatrics · 2025Guideline
- Guideline for Antibacterial Prophylaxis Administration in Pediatric Cancer and Hematopoietic Stem Cell Transplantation.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020Guideline
- Incidence of Induction Toxicities in Childhood Acute Lymphoblastic Leukaemia in Ghana.Advances in hematology · 2026Article
- Article
- Levofloxacin prophylaxis in pediatric oncology and hematopoietic stem cell transplantation: a literature review.Pediatric hematology and oncology · 2024Review
- Survival and Treatment Outcomes of Childhood Acute Lymphoblastic Leukemia in a Low-Middle Income Country: A Single-Center Experience in West Java, Indonesia.Journal of blood medicine · 2024Article
- Identifying Risk Factors and Improving Preventive Strategies for Febrile Neutropenia in Children with Leukemia Receiving Ciprofloxacin ProphylaxisTurkish journal of haematology : official journal of Turkish Society of Haematology · 2023Article
- Effectiveness of levofloxacin in the induction of chemotherapy in high-risk acute lymphoblastic leukaemia in children in a developing country.Ecancermedicalscience · 2023Article
- Effectiveness of Quinolone Prophylaxis in Pediatric Acute Leukemia and Hematopoietic Stem Cell Transplantation: A Systematic Review and Meta-analysis.Open forum infectious diseases · 2022Review
- Neutropenia and Infection Prophylaxis in Childhood Cancer.Current oncology reports · 2022Review
- Antibiotic Resistant Bloodstream Infections in Pediatric Patients Receiving Chemotherapy or Hematopoietic Stem Cell Transplant: Factors Associated with Development of Resistance, Intensive Care Admission and Mortality.Antibiotics (Basel, Switzerland) · 2021Article
- Antimicrobial Prophylaxis and Modifications of the Gut Microbiota in Children with Cancer.Antibiotics (Basel, Switzerland) · 2021Review
- Antibacterial prophylaxis in pediatric patients with leukemia.Saudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society · 2018Review
- Levofloxacin Prophylaxis During Induction Therapy for Pediatric Acute Lymphoblastic Leukemia.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2017Observational
- Antibiotic prophylaxis in acute childhood leukemia: What is known so far?Hematology, transfusion and cell therapyReview
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesToxic death is a big problem in the treatment of childhood acute lymphoblastic leukemia (ALL), especially in low-income countries. Studies of ciprofloxacin as single agent prophylaxis vary widely in success rate. We conducted a double-blind, randomized study to test the effects of ciprofloxacin monotherapy as prophylaxis for sepsis and death in induction treatment of the Indonesian childhood ALL protocol.
methodsPatients were randomized to the ciprofloxacin arm (n = 58) and to the placebo arm (n = 52). Oral ciprofloxacin monotherapy or oral placebo was administered twice a day. All events during induction were recorded: toxic death, abandonment, resistant disease, and complete remission rate.
resultsOf 110 patients enrolled in this study, 79 (71.8%) achieved CR. In comparison to the placebo arm, the ciprofloxacin arm had lower nadir of absolute neutrophil count during induction with median of 62 (range: 5-884) versus 270 (range: 14-25,480) × 10(9) cells/L (P < 0.01), greater risks for experiencing fever (50.0% versus 32.7%, P = 0.07), clinical sepsis (50.0% versus 38.5%, P = 0.22), and death (18.9% versus 5.8%, P = 0.05).
conclusionIn our setting, a reduced intensity protocol in a low-income situation, the data warn against using ciprofloxacin prophylaxis during induction treatment. A lower nadir of neutrophil count and higher mortality were found in the ciprofloxacin group.
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