Acute respiratory infections in children and adolescents with acute lymphoblastic leukemia

Hakim, Hana; Dallas, Ronald H.; Zhou, Yinmei; Pei, Dequing; Cheng, Cheng; Flynn, Patricia M.; Pui, Ching‐Hon; Jeha, Sima

doi:10.1002/cncr.29833

Cited by 55 publications

(62 citation statements)

References 21 publications

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“…Influenza is suggested to be a frequent pathogen of URTI both in immunocompetent and immunocompromised children. 14,15 In our series of children with cancer, HRV was found to be the most frequent (24.3%) viral respiratory tract infection pathogen. However, in most published series on pediatric cancer, HRV has not been included in the viral panel.…”

Section: Discussionmentioning

confidence: 74%

“…However, in most published series on pediatric cancer, HRV has not been included in the viral panel. 14,16 The high incidence of HRV can also be attributed to the inclusion of HRV in the diagnostic testing panels during recent years, which has led to similar cases. [17][18][19][20][21] In the present study, no seasonal differences were observed in the incidence of HRV infection; similarly, certain past studies have also reported the absence of any seasonal differences.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Respiratory viral infection`s frequency and clinical outcome in symptomatic children with cancer: A single center experience from a middle-income country

Büyükkapu-Bay¹,

Kebudi²,

Görgün³

et al. 2018

Turk J Pediatr

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Büyükkapu-Bay S, Kebudi R, Görgün Ö, Meşe S, Zülfikar B, Badur S. Respiratory viral infection's frequency and clinical outcome in symptomatic children with cancer: A single center experience from a middle-income country. Turk J Pediatr 2018; 60: 653-659.In developing countries, acute respiratory tract infections are a significant cause of morbidity and mortality in children, particularly in pediatric cancer patients. A majority of these illnesses are precipitated by viral infections. In our country, studies were conducted on the single respiratory viral infection in a pediatric hematology-oncology unit; however, the analysis of respiratory viral infections in children with cancer is lacking. The present study aimed to provide analysis of multiple respiratory viral infections and clinical outcome in children with cancer who receive chemotherapy and show signs and symptoms of respiratory tract infections. During January, 2014 and January, 2015 children with cancer under treatment who presented with respiratory tract infections were assessed for viruses by using multiplex real-time reverse transcription polymerase chain reaction (rRT-PCR). Specimens were collected by nasal swabbing at in-patient and out-patient clinics. Overall, 72 samples of respiratory tract infection episodes, collected from children with cancer were evaluated with the simultaneous detection of 20 respiratory viruses. A respiratory viral pathogen was obtained in 56.9% samples. Rhinovirus (24.3%) and co-infection with two viruses (19.5%) were the most frequently isolated pathogens. There were four (9.6%) samples of severe pneumonia. Patients with febrile neutropenic episodes and pneumonia were hospitalized and treated with broad-spectrum antibiotics. Other non-neutropenic and mild respiratory tract infections were treated with supportive care as outpatient procedures. There were no deaths. Because there are no effective antiviral agents for certain respiratory viruses, infection control and early diagnosis are crucial in preventing the spread of infection. Clinical findings and serological results of viral respiratory tract infections help us to accurately determine the treatment approach and avoid the unnecessary use of antibiotics.

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Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Respiratory viral infection`s frequency and clinical outcome in symptomatic children with cancer: A single center experience from a middle-income country

Büyükkapu-Bay¹,

Kebudi²,

Görgün³

et al. 2018

Turk J Pediatr

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“…Historically, research has focused on identifying pulmonary‐toxic therapies, such as radiation and hematopoietic stem cell transplant (HSCT), to inform risk‐based pulmonary follow‐up . However, respiratory infections are also a significant cause of pulmonary morbidity during treatment . In particular, recent studies using polymerase chain reaction (PCR) diagnostics have found respiratory viral infections (RVI) cause up to 57% of febrile episodes, and that children undergoing chemotherapy are at risk of more severe RVIs with a prolonged clinical course and higher viral loads …”

Section: Introductionmentioning

confidence: 99%

Long‐term morbidity of respiratory viral infections during chemotherapy in children with leukaemia

Lin

Kennedy

McBride

et al. 2019

Pediatric Pulmonology

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Background Respiratory viruses are a common cause of infection in immunosuppressed children undergoing cancer therapy. Pulmonary sequelae have been documented following respiratory viral infections (RVIs) in hematopoietic stem cell transplant (HSCT) recipients; however potential late effects in children undergoing nonmyeloablative chemotherapy have not been investigated. Aim To evaluate the long‐term pulmonary morbidity of respiratory viral infections during chemotherapy in children with acute lymphoblastic leukemia (ALL). Methods Childhood ALL survivors, aged 7 to 18 years, greater than 6 months posttreatment were recruited. Exclusion criteria included HSCT or proven bacterial/fungal respiratory infection during treatment. Subjects were classified into “viral” or “control” groups according to retrospective medical records that documented the presence of laboratory‐proven RVIs during chemotherapy. Symptom questionnaires (Liverpool, ISAAC) and lung function testing (spirometry, plethysmography, diffusing capacity, forced oscillation technique to ATS/ERS standards) were then performed cross‐sectionally at the time of recruitment. Results Fifty‐four patients (31 viral, 23 control) were recruited: median (range) age 11.2 (7.2‐18.1) years, and at 4.9 (0.5‐13) years posttherapy. Abnormalities were detected in 17 (31%) individuals (8 viral, 9 control), with the most common being DLCO impairment (3 viral, 4 control) and reduced respiratory reactance at 5 Hz (5 viral, 6 control). Children with RVIs during chemotherapy reported more current respiratory symptoms, particularly wheeze (odds ratio [OR], 3.0; 95% confidence interval [CI]: 0.9‐10.0; P = .09) and cough (OR, 2.7; 95% CI: 0.8‐9.5; P = .11). No differences in lung function tests were observed between the two groups. Conclusions Our study found children with RVIs during chemotherapy developed more long‐term respiratory symptoms than controls; however, differences did not reach statistical significance. No differences in static lung function were found between the two groups. Overall, pulmonary abnormalities and/or significant ongoing respiratory symptoms were detected in nearly a third of ALL survivors treated without HSCT. Larger, prospective studies are warranted to evaluate the etiology and clinical significance of these findings.

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“…Second to rhinovirus, the most represented virus is HRSV, found in 2.1-46% of cases. HMPV has been found in 3.3-13.5% of cases, being classified as the third [19], fourth [18,[20][21][22][23], fifth [24] and tenth [25,26] most frequent respiratory virus, according to the literature reviewed. Interestingly, HMPV has been reported as the only viral agent that was responsible for an outbreak in a pediatric oncology population [27] (Table 1).…”

Section: Distribution Of Respiratory Viruses In Pediatric Cancermentioning

confidence: 99%

HMPV in Immunocompromised Patients: Frequency and Severity in Pediatric Oncology Patients

Martinez-Rodriguez

Baños-Lara

2020

Pathogens

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Cancer is the first cause of death by disease in childhood globally. The most frequent types of cancers in children and adolescents are leukemias, followed by brain and central nervous system tumors and lymphomas. The recovery rate of cancer in children is around 80% in developed countries and up to 30% in developing countries. Some of the main causes of complications in children and adolescents with cancer are respiratory viral infections, mainly in bone marrow-transplanted patients. Respiratory viruses have been detected in the bronchoalveolar lavage or nasal wash specimens from cancer patients with or without respiratory illness symptoms. Human metapneumovirus (HMPV) is within the ten most common viruses that are encountered in samples from pediatric patients with underlying oncology conditions. In most of cases, HMPV is found as the only viral agent, but co-infection with other viruses or with bacterial agents has also been reported. The discrepancies between the most prevalent viral agents may be due to the different populations studied or the range of viral agents tested. Some of the cases of infection with HMPV in cancer patients have been fatal, especially in those who have received a hematopoietic stem cell transplant. This review seeks to show a general view of the participation of HMPV in respiratory illness as a complication of cancer in childhood and adolescence. Keywords: pediatric cancer infections; HMPV; fatal cases in HSCT patients Childhood Cancer Global SituationCancer is the first cause of death by disease in children around the world. The five-year rate of survival of children who have cancer is up to 80% in developed countries, but for developing countries, the survival rate is less than 30% [1].According to a study based in cancer registries from 52 countries, the types of cancer in childhood (0-19 years old) during 2001-2010 were leukemia, lymphoma, central nervous system tumors, sympathetic nervous system tumors, retinoblastoma, renal tumors, hepatic tumors, bone tumors, soft tissue sarcomas, germ cell and gonadal tumors, epithelial tumors, and melanomas. The most frequent cancers in children of 0-14 years are leukemia, followed by lymphoma; meanwhile, for the ages of 15-19, the most prevalent is lymphoma, followed by leukemia [2].Cancer in childhood comprises only 1% of the total cancer cases worldwide; however, it has a dramatic impact. Recently the years of life lost due to cancer in childhood (0-19 years old) were calculated with global cancer registries in 2017, with a result of more than 11 million years [3].

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Acute respiratory infections in children and adolescents with acute lymphoblastic leukemia

Cited by 55 publications

References 21 publications

Respiratory viral infection`s frequency and clinical outcome in symptomatic children with cancer: A single center experience from a middle-income country

Respiratory viral infection`s frequency and clinical outcome in symptomatic children with cancer: A single center experience from a middle-income country

Long‐term morbidity of respiratory viral infections during chemotherapy in children with leukaemia

HMPV in Immunocompromised Patients: Frequency and Severity in Pediatric Oncology Patients

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