Evidence map›Paper›PMID 39399884›Full record

ArticleInfection and drug resistance2024

Pediatric Acute Myeloid Leukemia: Unraveling Complexities in Intensive Chemotherapy and the Emergence of Superbugs - A Case Study.

Sandip Patil, Xinye Li, Huirong Mai, Ying Wang, Xue Tang, Sixi Liu, Feiqiu Wen

Abstract readCase Reports
In one paragraph

Article in Infection and drug resistance, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Sandip PatilDepartment of Haematology and Oncology, Shenzhen Children's Hospital, Shenzhen, Guangdong Province, People's Republic of China.ORCID 0000-0003-2736-9206
Xinye LiDepartment of Haematology and Oncology, Shenzhen Children's Hospital, Shenzhen, Guangdong Province, People's Republic of China.
Huirong MaiDepartment of Haematology and Oncology, Shenzhen Children's Hospital, Shenzhen, Guangdong Province, People's Republic of China.
Ying WangDepartment of Haematology and Oncology, Shenzhen Children's Hospital, Shenzhen, Guangdong Province, People's Republic of China.
Xue TangDepartment of Haematology and Oncology, Shenzhen Children's Hospital, Shenzhen, Guangdong Province, People's Republic of China.
Sixi LiuDepartment of Haematology and Oncology, Shenzhen Children's Hospital, Shenzhen, Guangdong Province, People's Republic of China.
Feiqiu WenDepartment of Haematology and Oncology, Shenzhen Children's Hospital, Shenzhen, Guangdong Province, People's Republic of China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: This case report underscores the intricate challenges in managing paediatric patients with acute myeloid leukaemia (AML) undergoing intensive chemotherapy, particularly when complicated by the emergence of multidrug-resistant pathogens such as Carbapenem-Resistant Case Presentation: An 11-year-old male with AML presented with skin purpura and persistent cough. Clinical and laboratory assessments revealed a high-risk AML profile with genetic mutations, leading to the initiation of intensive chemotherapy per the C-HUANA-AML-2015 protocol. Despite successful disease remission after initial chemotherapy courses, the patient experienced unexpected complications. Notably, septic shock, bone marrow failure, and the emergence of CRPA were encountered during the clinical course. Septic shock occurred following Course B3 chemotherapy, marked by a fever unresponsive to initial antibiotic therapy. Despite negative blood cultures, meropenem and vancomycin were initiated, successfully normalizing temperature. Subsequent challenges included persistent bone marrow suppression, perianal dermatitis, and the identification of CRPA in stool cultures, leading to altered antibiotic therapy guided by minimum inhibitory concentration (MIC) considerations. Whole-genome sequencing (WGS) of the CRPA strain revealed a highly virulent clone (ST-970) with numerous resistance and virulence genes. Conclusion: This case report offers new insights into the complexities of pediatric AML management, with a focus on the emergence of CRPA. The discovery of a high-risk CRPA clone with detailed genomic data underscores the growing challenge of antimicrobial resistance in pediatric oncology. The persistent presence of CRPA and ongoing bone marrow failure highlight the difficulties in managing these complications. This case calls for a reassessment of treatment strategies and encourages further research to improve outcomes in pediatric AML, emphasizing the need for a multidisciplinary approach to address infectious complications and antimicrobial resistance.

Indexed as

acute myeloid leukaemiaantimicrobial resistancecarbapenem-resistant Pseudomonas aeruginosapaediatric oncologysuperbugs

Identifiers

PMID39399884
PMCPMC11471062

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.