Key clinical point: Levofloxacin prophylaxis significantly reduced bacteremia in children with acute leukemias undergoing intensive chemotherapy, but not in children undergoing hematopoietic stem cell transplantation (HSCT).
Major finding: Bacteremia likelihood was 21.9% versus 43.4% for prophylaxis and no prophylaxis, respectively, in the acute leukemias group (P = 0.001), and 11.0% versus 17.3% in the HSCT group (P = 0.06).
Study details: A randomized phase 3 clinical trial, including 200 patients with acute leukemias and 424 patients undergoing HSCT.
Disclosures: The research was supported by grants from the Community Clinical Oncology Program and National Cancer Institute. Study authors reported disclosures related to Bristol-Myers Squibb, Chimerix, Jazz Pharmaceuticals, and the Children’s Oncology Group.
Alexander S, et al. JAMA. 2018;320(10):995-1004.
This Week's Must Reads
Consider bleeding disorders in heavy menstrual bleeding, O’Brien B et al. J Pediatr Adolesc Gynecol. 2018 Nov 22 . doi: 10.1016/j.jpag.2018.11.005
Lower-dose treatment could save money in aTTP, Zwicker JI et al. ASH 2018, Abstract 374
Low rates of bleeding with DOAC interruption, Douketis J et al. ASH 2018, Abstract LBA-5
Gene therapy in severe hemophilia B, Reiss UM et al. ASH 2018, Abstract 491
Luspatercept reduced transfusion burden in trial, List AF et al. ASH 2018, abstract 1
Must Reads in ALL
Immune system changes play a role in AML relapse, Christopher MJ et al. N Engl J Med. 2018 Oct 31. doi: 10.1056/NEJMoa1808777.
CAR T-cell cost effectiveness in ALL, Whittington MD et al. JAMA Pediatr. 2018 Oct 8. doi: 10.1001/jamapediatrics.2018.2530
CAR T induced resistance in ALL, Ruella M et al. Nat Med. 2018 Oct 1. doi: 10.1038/s41591-018-0201-9
ALL complications carry cognitive risks, Cheung YT et al. JAMA Pediatr. 2018 Sep 24. doi:10.1001/jamapediatrics.2018.2500.
Levofloxacin prophylaxis in ALL, AML , Alexander S, et al. JAMA. 2018;320(10):995-1004