[Analysis of causes of XXXX during intensive chemotherapy according to treatment protocol @entity3052 -BFM 93].

@entity1 @entity455 @entity59275 @entity943 @entity548 @entity3052 @entity281 @entity364 @entity2132 @entity1778 @entity1398 @entity3 @entity204 @entity166
BACKGROUND: During intensive chemotherapy for @entity3052 , more than 10% of @entity1 die because of treatment complications but not because of progression of their underlying disease. In order to improve supportive care and to decrease mortality, we analysed the causes of @entity204 and their relationship to the cycles of chemotherapy in @entity1 undergoing treatment for @entity3052 according to the study @entity3052 -BFM 93. RESULTS: Thirty-five (7.4%) of a total of 471 @entity1 treated according to protocol @entity3052 -BFM 93 died before or within the first 6 weeks after diagnosis ( @entity204 ). Fourty-nine @entity1 (10%) did not achieve remission, and 18 (4 %) died of therapy-related complications after having achieved remission. In comparison to earlier @entity3052 -BFM studies, early mortality was reduced from 13%, 12%, 9% ( @entity3052 - @entity59275 , 83, 87) to 7% ( @entity3052 -BFM 93, p-trend = 0.03). In contrast, mortality of @entity1 in complete continuous remission (CCR) did not change. @entity166 , in particular due to @entity364 , were the main cause of @entity204 . One @entity1 died of @entity943 associated with SIAD. After stem-cell transplantation in first remission, 7 of 51 @entity1 died, mainly because of @entity2132 . The incidence of infectious complications decreased with the number of chemotherapy cycles and was highest during induction therapy. @entity455 occurred in one @entity1 during maintenance therapy and in one @entity1 thereafter; both @entity1 were in CCR. Another 14 @entity1 died during intensive therapy (before day 150) mostly with a low percentage of blasts, but no haematologic recovery. The cause of @entity204 in these @entity1 was mainly bacterial @entity281 or @entity3 , but seldom progression of @entity1778 . CONCLUSION: This analysis confirmed the high incidence of @entity281 in @entity1 with @entity3052 during chemotherapy-induced severe @entity1398 . To increase overall survival in @entity1 undergoing therapy for @entity3052 , we propose (1) to improve the prophylactic and therapeutic measures for @entity548 and @entity281 , (2) to continue risk-adapted therapy and (3) to treat high-risk @entity1 in specialised centres only.
