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1.
J Exp Bot ; 68(8): 2037-2054, 2017 04 01.
Article in English | MEDLINE | ID: mdl-28338822

ABSTRACT

Pigeonpea (Cajanus cajan) is an important grain legume of the semi-arid tropics, mainly used for its protein rich seeds. To link the genome sequence information with agronomic traits resulting from specific developmental processes, a Cajanus cajan gene expression atlas (CcGEA) was developed using the Asha genotype. Thirty tissues/organs representing developmental stages from germination to senescence were used to generate 590.84 million paired-end RNA-Seq data. The CcGEA revealed a compendium of 28 793 genes with differential, specific, spatio-temporal and constitutive expression during various stages of development in different tissues. As an example to demonstrate the application of the CcGEA, a network of 28 flower-related genes analysed for cis-regulatory elements and splicing variants has been identified. In addition, expression analysis of these candidate genes in male sterile and male fertile genotypes suggested their critical role in normal pollen development leading to seed formation. Gene network analysis also identified two regulatory genes, a pollen-specific SF3 and a sucrose-proton symporter, that could have implications for improvement of agronomic traits such as seed production and yield. In conclusion, the CcGEA provides a valuable resource for pigeonpea to identify candidate genes involved in specific developmental processes and to understand the well-orchestrated growth and developmental process in this resilient crop.


Subject(s)
Cajanus/genetics , Crops, Agricultural/genetics , Fertility/genetics , Gene Expression Regulation, Plant , Genes, Plant/physiology , Pollination/genetics , Seeds/genetics , Cajanus/physiology , Crops, Agricultural/physiology , Fertility/physiology , Pollination/physiology , Seeds/physiology
2.
PLoS One ; 11(10): e0164340, 2016.
Article in English | MEDLINE | ID: mdl-27768702

ABSTRACT

An association mapping panel, named as CIMMYT Asia association mapping (CAAM) panel, involving 396 diverse tropical maize lines were phenotyped for various structural and functional traits of roots under drought and well-watered conditions. The experiment was conducted during Kharif (summer-rainy) season of 2012 and 2013 in root phenotyping facility at CIMMYT-Hyderabad, India. The CAAM panel was genotyped to generate 955, 690 SNPs through GBS v2.7 using Illumina Hi-seq 2000/2500 at Institute for Genomic Diversity, Cornell University, Ithaca, NY, USA. GWAS analysis was carried out using 331,390 SNPs filtered from the entire set of SNPs revealed a total of 50 and 67 SNPs significantly associated for root functional (transpiration efficiency, flowering period water use) and structural traits (rooting depth, root dry weight, root length, root volume, root surface area and root length density), respectively. In addition to this, 37 SNPs were identified for grain yield and shoot biomass under well-watered and drought stress. Though many SNPs were found to have significant association with the traits under study, SNPs that were common for more than one trait were discussed in detail. A total 18 SNPs were found to have common association with more than one trait, out of which 12 SNPs were found within or near the various gene functional regions. In this study we attempted to identify the trait specific maize lines based on the presence of favorable alleles for the SNPs associated with multiple traits. Two SNPs S3_128533512 and S7_151238865 were associated with transpiration efficiency, shoot biomass and grain yield under well-watered condition. Based on favorable allele for these SNPs seven inbred lines were identified. Similarly, four lines were identified for transpiration efficiency and shoot biomass under drought stress based on the presence of favorable allele for the common SNPs S1_211520521, S2_20017716, S3_57210184 and S7_130878458 and three lines were identified for flowering period water-use, transpiration efficiency, root dry weight and root volume based on the presence of favorable allele for the common SNPs S3_162065732 and S3_225760139.


Subject(s)
Droughts , Genome, Plant , Plant Roots/physiology , Stress, Physiological , Tropical Climate , Linkage Disequilibrium , Phenotype , Polymorphism, Single Nucleotide
3.
PLoS One ; 10(4): e0122847, 2015.
Article in English | MEDLINE | ID: mdl-25849964

ABSTRACT

Gene expression analysis using quantitative real-time PCR (qRT-PCR) is a very sensitive technique and its sensitivity depends on the stable performance of reference gene(s) used in the study. A number of housekeeping genes have been used in various expression studies in many crops however, their expression were found to be inconsistent under different stress conditions. As a result, species specific housekeeping genes have been recommended for different expression studies in several crop species. However, such specific housekeeping genes have not been reported in the case of pigeonpea (Cajanus cajan) despite the fact that genome sequence has become available for the crop. To identify the stable housekeeping genes in pigeonpea for expression analysis under drought stress conditions, the relative expression variations of 10 commonly used housekeeping genes (EF1α, UBQ10, GAPDH, 18SrRNA, 25SrRNA, TUB6, ACT1, IF4α, UBC and HSP90) were studied on root, stem and leaves tissues of Asha (ICPL 87119). Three statistical algorithms geNorm, NormFinder and BestKeeper were used to define the stability of candidate genes. geNorm analysis identified IF4α and TUB6 as the most stable housekeeping genes however, NormFinder analysis determined IF4α and HSP90 as the most stable housekeeping genes under drought stress conditions. Subsequently validation of the identified candidate genes was undertaken in qRT-PCR based gene expression analysis of uspA gene which plays an important role for drought stress conditions in pigeonpea. The relative quantification of the uspA gene varied according to the internal controls (stable and least stable genes), thus highlighting the importance of the choice of as well as validation of internal controls in such experiments. The identified stable and validated housekeeping genes will facilitate gene expression studies in pigeonpea especially under drought stress conditions.


Subject(s)
Cajanus/genetics , Cajanus/physiology , Droughts , Gene Expression Profiling/standards , Genes, Plant/genetics , Stress, Physiological/genetics , Algorithms , Genes, Essential/genetics , Reference Standards , Reproducibility of Results
4.
Front Plant Sci ; 6: 1071, 2015.
Article in English | MEDLINE | ID: mdl-27242803

ABSTRACT

To identify stable housekeeping genes as a reference for expression analysis under heat and salt stress conditions in pigeonpea, the relative expression variation for 10 commonly used housekeeping genes (EF1α, UBQ10, GAPDH, 18Sr RNA, 25Sr RNA, TUB6, ACT1, IF4α, UBC, and HSP90) was studied in root, stem, and leaves tissues of Asha (ICPL 87119), a leading pigeonpea variety. Three statistical algorithms geNorm, NormFinder, and BestKeeper were used to define the stability of candidate genes. Under heat stress, UBC, HSP90, and GAPDH were found to be the most stable reference genes. In the case of salinity stress, GAPDH followed by UBC and HSP90 were identified to be the most stable reference genes. Subsequently, the above identified genes were validated using qRT-PCR based gene expression analysis of two universal stress-resposive genes namely uspA and uspB. The relative quantification of these two genes varied according to the internal controls (most stable, least stable, and combination of most stable and least stable housekeeping genes) and thus confirmed the choice as well as validation of internal controls in such experiments. The identified and validated housekeeping genes will facilitate gene expression studies under heat and salt stress conditions in pigeonpea.

5.
Front Plant Sci ; 6: 1065, 2015.
Article in English | MEDLINE | ID: mdl-26779199

ABSTRACT

Pigeonpea is a resilient crop, which is relatively more drought tolerant than many other legume crops. To understand the molecular mechanisms of this unique feature of pigeonpea, 51 genes were selected using the Hidden Markov Models (HMM) those codes for proteins having close similarity to universal stress protein domain. Validation of these genes was conducted on three pigeonpea genotypes (ICPL 151, ICPL 8755, and ICPL 227) having different levels of drought tolerance. Gene expression analysis using qRT-PCR revealed 6, 8, and 18 genes to be ≥2-fold differentially expressed in ICPL 151, ICPL 8755, and ICPL 227, respectively. A total of 10 differentially expressed genes showed ≥2-fold up-regulation in the more drought tolerant genotype, which encoded four different classes of proteins. These include plant U-box protein (four genes), universal stress protein A-like protein (four genes), cation/H(+) antiporter protein (one gene) and an uncharacterized protein (one gene). Genes C.cajan_29830 and C.cajan_33874 belonging to uspA, were found significantly expressed in all the three genotypes with ≥2-fold expression variations. Expression profiling of these two genes on the four other legume crops revealed their specific role in pigeonpea. Therefore, these genes seem to be promising candidates for conferring drought tolerance specifically to pigeonpea.

6.
J Biosci ; 37(5): 811-20, 2012 Nov.
Article in English | MEDLINE | ID: mdl-23107917

ABSTRACT

Molecular markers are the most powerful genomic tools to increase the efficiency and precision of breeding practices for crop improvement. Progress in the development of genomic resources in the leading legume crops of the semi-arid tropics (SAT), namely, chickpea (Cicer arietinum), pigeonpea (Cajanus cajan) and groundnut (Arachis hypogaea), as compared to other crop species like cereals, has been very slow. With the advances in next-generation sequencing (NGS) and high-throughput (HTP) genotyping methods, there is a shift in development of genomic resources including molecular markers in these crops. For instance, 2,000 to 3,000 novel simple sequence repeats (SSR) markers have been developed each for chickpea, pigeonpea and groundnut. Based on Sanger, 454/FLX and Illumina transcript reads, transcriptome assemblies have been developed for chickpea (44,845 transcript assembly contigs, or TACs) and pigeonpea (21,434 TACs). Illumina sequencing of some parental genotypes of mapping populations has resulted in the development of 120 million reads for chickpea and 128.9 million reads for pigeonpea. Alignment of these Illumina reads with respective transcriptome assemblies have provided more than 10,000 SNPs each in chickpea and pigeonpea. A variety of SNP genotyping platforms including GoldenGate, VeraCode and Competitive Allele Specific PCR (KASPar) assays have been developed in chickpea and pigeonpea. By using above resources, the first-generation or comprehensive genetic maps have been developed in the three legume speciesmentioned above. Analysis of phenotyping data together with genotyping data has provided candidate markers for drought-tolerance-related root traits in chickpea, resistance to foliar diseases in groundnut and sterility mosaic disease (SMD) and fertility restoration in pigeonpea. Together with these traitassociated markers along with those already available, molecular breeding programmes have been initiated for enhancing drought tolerance, resistance to fusarium wilt and ascochyta blight in chickpea and resistance to foliar diseases in groundnut. These trait-associated robust markers along with other genomic resources including genetic maps and genomic resources will certainly accelerate crop improvement programmes in the SAT legumes.


Subject(s)
Arachis/genetics , Cajanus/genetics , Cicer/genetics , DNA Shuffling , Plant Diseases/genetics , Quantitative Trait Loci , Alleles , Arachis/immunology , Cajanus/immunology , Chromosome Mapping , Cicer/immunology , Droughts , Expressed Sequence Tags , High-Throughput Nucleotide Sequencing , Microsatellite Repeats , Plant Diseases/immunology , Polymorphism, Single Nucleotide , Transcriptome , Tropical Climate
7.
Mol Breed ; 30(2): 757-772, 2012 Aug.
Article in English | MEDLINE | ID: mdl-22924017

ABSTRACT

Groundnut (Arachis hypogaea L.) is an important food and cash crop grown mainly in semi-arid tropics (SAT) regions of the world where drought is the major constraint on productivity. With the aim of understanding the genetic basis and identification of quantitative trait loci (QTL) for drought tolerance, two new recombinant inbred line (RIL) mapping populations, namely ICGS 76 × CSMG 84-1 (RIL-2) and ICGS 44 × ICGS 76 (RIL-3), were used. After screening of 3,215 simple sequence repeat (SSR) markers on the parental genotypes of these populations, two new genetic maps were developed with 119 (RIL-2) and 82 (RIL-3) SSR loci. Together with these maps and the reference map with 191 SSR loci based on TAG 24 × ICGV 86031 (RIL-1), a consensus map was constructed with 293 SSR loci distributed over 20 linkage groups, spanning 2,840.8 cM. As all these three populations segregate for drought-tolerance-related traits, a comprehensive QTL analysis identified 153 main effect QTL (M-QTL) and 25 epistatic QTL (E-QTL) for drought-tolerance-related traits. Localization of these QTL on the consensus map provided 16 genomic regions that contained 125 QTL. A few key genomic regions were selected on the basis of the QTL identified in each region, and their expected role in drought adaptation is also discussed. Given that no major QTL for drought adaptation were identified, novel breeding approaches such as marker-assisted recurrent selection (MARS) and genomic selection (GS) approaches are likely to be the preferred approaches for introgression of a larger number of QTL in order to breed drought-tolerant groundnut genotypes. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s11032-011-9660-0) contains supplementary material, which is available to authorized users.

8.
Front Physiol ; 3: 179, 2012.
Article in English | MEDLINE | ID: mdl-22675307

ABSTRACT

The chickpea and pigeonpea are protein-rich grain legumes used for human consumption in many countries. Grain yield of these crops is low to moderate in the semi-arid tropics with large variation due to high GxE interaction. In the Indian subcontinent chickpea is grown in the post-rainy winter season on receding soil moisture, and in other countries during the cool and dry post winter or spring seasons. The pigeonpea is sown during rainy season which flowers and matures in post-rainy season. The rainy months are hot and humid with diurnal temperature varying between 25 and 35°C (maximum) and 20 and 25°C (minimum) with an erratic rainfall. The available soil water during post-rainy season is about 200-250 mm which is bare minimum to meet the normal evapotranspiration. Thus occurrence of drought is frequent and at varying degrees. To enhance productivity of these crops cultivars tolerant to drought need to be developed. ICRISAT conserves a large number of accessions of chickpea (>20,000) and pigeonpea (>15,000). However only a small proportion (<1%) has been used in crop improvement programs mainly due to non-availability of reliable information on traits of economic importance. To overcome this, core and mini core collections (10% of core, 1% of entire collection) have been developed. Using the mini core approach, trait-specific donor lines were identified for agronomic, quality, and stress related traits in both crops. Composite collections were developed both in chickpea (3000 accessions) and pigeonpea (1000 accessions), genotyped using SSR markers and genotype based reference sets of 300 accessions selected for each crop. Screening methods for different drought-tolerant traits such as early maturity (drought escape), large and deep root system, high water-use efficiency, smaller leaflets, reduced canopy temperature, carbon isotope discrimination, high leaf chlorophyll content (drought avoidance), and breeding strategies for improving drought tolerance have been discussed.

9.
Plant Cell Environ ; 33(4): 490-509, 2010 Apr.
Article in English | MEDLINE | ID: mdl-19843257

ABSTRACT

The growth of chickpea (Cicer arietinum L.) is very sensitive to salinity, with the most susceptible genotypes dying in just 25 mm NaCl and resistant genotypes unlikely to survive 100 mm NaCl in hydroponics; germination is more tolerant with some genotypes tolerating 320 mm NaCl. When growing in a saline medium, Cl(-), which is secreted from glandular hairs on leaves, stems and pods, is present in higher concentrations in shoots than Na(+). Salinity reduces the amount of water extractable from soil by a chickpea crop and induces osmotic adjustment, which is greater in nodules than in leaves or roots. Chickpea rhizobia show a higher 'free-living' salt resistance than chickpea plants, and salinity can cause large reductions in nodulation, nodule size and N(2)-fixation capacity. Recent screenings of diverse germplasm suggest significant variation of seed yield under saline conditions. Both dominance and additive gene effects have been identified in the effects of salinity on chickpea and there appears to be sufficient genetic variation to enable improvement in yield under saline conditions via breeding. Selections are required across the entire life cycle with a range of rhizobial strains under salt-affected, preferably field, conditions.


Subject(s)
Cicer/drug effects , Sodium Chloride/pharmacology , Cicer/genetics , Cicer/growth & development , Cicer/microbiology , Gene Expression Regulation, Plant , Germination , Nitrogen Fixation , Rhizobium/drug effects , Root Nodules, Plant/growth & development , Root Nodules, Plant/metabolism , Salinity , Water/metabolism
10.
Plant Biol (Stuttg) ; 11 Suppl 1: 124-30, 2009 Nov.
Article in English | MEDLINE | ID: mdl-19778376

ABSTRACT

Transpiration efficiency (TE) is an important trait for drought tolerance in peanut (Arachis hypogaea L.). The variation in TE was assessed gravimetrically using a long time interval in nine peanut genotypes (Chico, ICGS 44, ICGV 00350, ICGV 86015, ICGV 86031, ICGV 91114, JL 24, TAG 24 and TMV 2) grown in lysimeters under well-watered or drought conditions. Transpiration was measured by regularly weighing the lysimeters, in which the soil surface was mulched with a 2-cm layer of polythene beads. TE in the nine genotypes used varied from 1.4 to 2.9 g kg(-1) under well-watered and 1.7 to 2.9 g kg(-1) under drought conditions, showing consistent variation in TE among genotypes. A higher TE was found in ICGV 86031 in both well-watered and drought conditions and lower TE was found in TAG-24 under both water regimes. Although total water extraction differed little across genotypes, the pattern of water extraction from the soil profile varied among genotypes. High water extraction within 24 days following stress imposition was negatively related to pod yield (r(2) = 0.36), and negatively related to water extraction during a subsequent period of 32 days (r(2) = 0.73). By contrast, the latter, i.e. water extraction during a period corresponding to grain filling (24 to 56 days after flowering) was positively related to pod yield (r(2) = 0.36). TE was positively correlated with pod weight (r(2) = 0.30) under drought condition. Our data show that under an intermittent drought regime, TE and water extraction from the soil profile during a period corresponding to pod filling were the most important components.


Subject(s)
Arachis/metabolism , Arachis/physiology , Droughts , Plant Transpiration/physiology , Soil/analysis
11.
Theor Appl Genet ; 118(4): 729-39, 2009 Feb.
Article in English | MEDLINE | ID: mdl-19048225

ABSTRACT

Molecular markers and genetic linkage maps are pre-requisites for molecular breeding in any crop species. In case of peanut or groundnut (Arachis hypogaea L.), an amphidiploid (4X) species, not a single genetic map is, however, available based on a mapping population derived from cultivated genotypes. In order to develop a genetic linkage map for tetraploid cultivated groundnut, a total of 1,145 microsatellite or simple sequence repeat (SSR) markers available in public domain as well as unpublished markers from several sources were screened on two genotypes, TAG 24 and ICGV 86031 that are parents of a recombinant inbred line mapping population. As a result, 144 (12.6%) polymorphic markers were identified and these amplified a total of 150 loci. A total of 135 SSR loci could be mapped into 22 linkage groups (LGs). While six LGs had only two SSR loci, the other LGs contained 3 (LG_AhXV) to 15 (LG_AhVIII) loci. As the mapping population used for developing the genetic map segregates for drought tolerance traits, phenotyping data obtained for transpiration, transpiration efficiency, specific leaf area and SPAD chlorophyll meter reading (SCMR) for 2 years were analyzed together with genotyping data. Although, 2-5 QTLs for each trait mentioned above were identified, the phenotypic variation explained by these QTLs was in the range of 3.5-14.1%. In addition, alignment of two linkage groups (LGs) (LG_AhIII and LG_AhVI) of the developed genetic map was shown with available genetic maps of AA diploid genome of groundnut and Lotus and Medicago. The present study reports the construction of the first genetic map for cultivated groundnut and demonstrates its utility for molecular mapping of QTLs controlling drought tolerance related traits as well as establishing relationships with diploid AA genome of groundnut and model legume genome species. Therefore, the map should be useful for the community for a variety of applications.


Subject(s)
Arachis/genetics , Chromosome Mapping , Minisatellite Repeats/genetics , Polymorphism, Genetic , Quantitative Trait Loci/genetics , Crosses, Genetic , Phenotype
12.
Bioinformatics ; 19(8): 930-7, 2003 May 22.
Article in English | MEDLINE | ID: mdl-12761054

ABSTRACT

MOTIVATION: During the next phase of the Human Genome Project, research will focus on functional studies of attributing functions to genes, their regulatory elements, and other DNA sequences. To facilitate the use of genomic information in such studies, a new modeling perspective is needed to examine and study genome sequences in the context of many kinds of biological information. Pathways are the logical format for modeling and presenting such information in a manner that is familiar to biological researchers. RESULTS: In this paper we present an integrated system, called Pathways Database System, with a set of software tools for modeling, storing, analyzing, visualizing, and querying biological pathways data at different levels of genetic, molecular, biochemical and organismal detail. The novel features of the system include: (a) genomic information integrated with other biological data and presented from a pathway, rather than from the DNA sequence, perspective; (b) design for biologists who are possibly unfamiliar with genomics, but whose research is essential for annotating gene and genome sequences with biological functions; (c) database design, implementation and graphical tools which enable users to visualize pathways data in multiple abstraction levels, and to pose predetermined queries; and (d) an implementation that allows for web(XML)-based dissemination of query outputs (i.e. pathways data) to researchers in the community, giving them control on the use of pathways data. AVAILABILITY: Available on request from the authors.


Subject(s)
Databases, Genetic , Metabolism/physiology , Models, Biological , Software , User-Computer Interface , Database Management Systems , Databases, Factual , Information Storage and Retrieval/methods , Metabolism/genetics , Software Design , Systems Integration
13.
Chapingo; Universidad Autónoma Chapingo; 1998. 331 p.
Monography in Spanish | LILACS | ID: lil-235827

ABSTRACT

Destaca la importancia de los espacios verdes y su papel estratégico, así como llama la atención para correlacionar materias que surgen de la subdivisión de las áreas verdes urbanas en públicas y privadas. Es comentada la mayor autonomía dada a los gobiernos locales, por obligación impuesta en la nueva Constitución Federal Brasileña expedida en 1988. Los efectos institucionales y operacionales, en la perspectiva de las políticas y acciones ambientales de la ciudad de Säo Paulo, que ocurrieron a lo largo de esta restructuración, con especial consideración al enverdecimiento urbano, son tratados aquí. Es presentado un enfoque cercano para darse una idea del marco legal de la ciudad de Säo Paulo, son descritos los proyetos en marcha de enverdecimiento urbano a gran escala, que se llevan a cabo actualmente por el gobierno de Säo Paulo con la colaboración y la participación organizada y no organizada de la sociedad civil. Los beneficios del enverdecimiento urbano son sistemáticamente listados y evaluados cíticamente, tomando en cuenta los descubrimientos de los investigadores nacionales y extranjeros


Subject(s)
Environment Design , Urban Health , Trees , Brazil , Caribbean Region , Latin America , Urban Area
18.
Indian Pediatr ; 29(7): 843-9, 1992 Jul.
Article in English | MEDLINE | ID: mdl-1428132

ABSTRACT

Introduction of CNS chemoprophylaxis was a major milestone in the development of current therapy for acute lymphocytic leukemia. However, controversies are still existing for ideal form of CNS chemoprophylaxis. The present study was conducted to determine the efficacy of intrathecal methotrexate (IT-MTX) with and without cranial radiotherapy in preventing CNS relapses in Indian children. CNS chemoprophylaxis comprising of six injections of intrathecal methotrexate (12 mg/M2) was administered alone or along with cranial radiotherapy (2000 GY) in 76 children each after successful induction remission. Cranial radiotherapy (RT) with intrathecal methotrexate (IT-MTX) was observed to be more effective as CNS relapses were seen in 11.8% of children as compared to 16.8% of children receiving IT-MTX alone. IT-MTX along with cranial RT delayed the occurrence of CNS relapses and prolonged the event free survival periods.


Subject(s)
Brain/pathology , Methotrexate/therapeutic use , Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy , Adolescent , Child , Child, Preschool , Combined Modality Therapy , Female , Humans , Infant , Injections, Spinal , Male , Precursor Cell Lymphoblastic Leukemia-Lymphoma/radiotherapy , Recurrence , Remission Induction , Treatment Outcome
19.
Indian Pediatr ; 29(6): 709-13, 1992 Jun.
Article in English | MEDLINE | ID: mdl-1500128

ABSTRACT

Fifty five deaths between January, 1982 to September, 1989 in children with acute lymphoblastic leukemia (ALL) were evaluated to determine the cause of mortality. Fifty cases died during remission. Infection alone was responsible for death in 26 of 55 (47.3%) cases while hemorrhage was seen in 7 (12.7%) children. Infection and hemorrhage together were responsible in another 13 cases. Gastrointestinal tract and pulmonary system were the major sites of bleeding. Infections either alone or in combination with other factors were responsible for death in 42 of 55 (76.5%) of children. Septicemia (n = 11), gastrointestinal (n = 15) and pulmonary infections (n = 10) and meningitis in 2 cases were the major sites of infections. Pseudomonas and Klebsiella in 6 cases each accounted for 54.5% of isolates.


PIP: New developments in case management presently afford cures to more than 60% of children with acute lymphoblastic leukemia (ALL). 287 children diagnosed with ALL were admitted to the All India Institute of Medical Sciences over the period January, 1982 - September, 1989, where they began chemotherapy. 50 died during initial or subsequent induction therapy and 5 died during the maintenance phase. All deaths were subsequently reviewed to identify the causes of mortality. Infection alone caused death in 47.3% of cases, hemorrhage was observed among 12.7%, and infection together with hemorrhage killed another 13 children. Septicemia, gastrointestinal, and pulmonary infections in 11, 15, and 10 cases, respectively, and meningitis in 2 cases were major sites or infection. Pseudomonas and Klebsiella in 6 cases each accounted for 54.5% of isolates. The gastrointestinal tract and pulmonary system were major sites of bleeding. While no definite cause of death was found for 5 cases, infections nonetheless either alone or combined with other factors caused 76.5% of deaths. To improve the long-term event free survival of children with ALL, practitioners must be knowledgeable about the potential spectrum of infections, begin treatment early with appropriate antibiotics, and seek to improve the availability of supportive facilities and modern antibiotics.


Subject(s)
Precursor Cell Lymphoblastic Leukemia-Lymphoma/mortality , Cause of Death , Child , Female , Humans , India , Male
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