%0 Journal Article
%T Randomized double blind trial of ciprofloxacin prophylaxis during induction treatment in childhood acute lymphoblastic leukemia in the WK-ALL protocol in Indonesia
%A Widjajanto PH
%A Sumadiono S
%A Cloos J
%A Purwanto I
%A Sutaryo S
%A Veerman AJP
%J Journal of Blood Medicine
%D 2013
%I 
%R http://dx.doi.org/10.2147/JBM.S33906
%X ndomized double blind trial of ciprofloxacin prophylaxis during induction treatment in childhood acute lymphoblastic leukemia in the WK-ALL protocol in Indonesia Original Research (473) Total Article Views Authors: Widjajanto PH, Sumadiono S, Cloos J, Purwanto I, Sutaryo S, Veerman AJP Published Date February 2013 Volume 2013:4 Pages 1 - 9 DOI: http://dx.doi.org/10.2147/JBM.S33906 Received: 16 May 2012 Accepted: 31 July 2012 Published: 01 February 2013 Pudjo H Widjajanto,1 Sumadiono Sumadiono,1 Jacqueline Cloos,2,3 Ignatius Purwanto,1 Sutaryo Sutaryo,1 Anjo JP Veerman1,2 1Pediatric Hematology and Oncology Division, Department of Pediatrics, Dr Sardjito Hospital, Medical Faculty, Universitas Gadjah Mada, Yogyakarta, Indonesia; 2Pediatric Oncology/Hematology Division, Department of Pediatrics, 3Department of Hematology, VU University Medical Center, Amsterdam, The Netherlands Objectives: Toxic 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. Methods: Patients 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. Results: Of 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¨C884) versus 270 (range: 14¨C25,480) ¡Á 109 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). Conclusion: In 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.
%K ciprofloxacin
%K prophylaxis
%K childhood acute lymphoblastic leukemia
%K randomized trial
%K low-income country
%U https://www.dovepress.com/randomized-double-blind-trial-of-ciprofloxacin-prophylaxis-during-indu-peer-reviewed-article-JBM