Infectious profile in children with ALL during chemotherapy: A report of study group for infections

Zawitkowska, Joanna; Drabko, Katarzyna; Szmydki‐Baran, Anna; Zaucha‐Prażmo, Agnieszka; Lejman, Monika; Czyżewski, K; Zalas‐Więcek, Patrycja; Gryniewicz–Kwiatkowska, Olga; Czajńska‐Deptuła, Aneta; Kulicka, Elwira; Semczuk, Katarzyna; Hutnik, Łukasz; Chełmecka‐Wiktorczyk, Liliana; Klepacka, Joanna; Frączkiewicz, Jowita; Salamonowicz, Małgorzata; Tomaszewska, Renata; Zając‐Spychała, Olga; Irga‐Jaworska, Ninela; Bień, Ewa; Płonowski, Marcin; Bartnik, Magdalena; Ociepa, Tomasz; Pierlejewski, Filip; Woszczyk, Mariola; Gamrot‐Pyka, Zuzanna; Małas, Zofia; Urbanek‐Dądela, Agnieszka; Stolpa, Weronika; Musiał, J.; Styczyński, Jan

doi:10.1016/j.jiac.2019.04.005

Cited by 17 publications

(17 citation statements)

References 15 publications

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“…Non‐AML/MDS underlying disease was associated with a 1.2‐fold increased risk for any infection. Although AML patients are classically at high risk for infection, in particular IFD, 37‐39 recent reports suggest that the incidence of IFD in ALL patients may be increasing 40,41 . It should be noted that transplantation in center 3 was protective for any infection.…”

Section: Discussionmentioning

confidence: 99%

“…Although AML patients are classically at high risk for infection, in particular IFD, 37-39 recent reports suggest that the incidence of IFD in ALL patients may be increasing. 40,41 It should be noted that transplantation in center 3 was protective for any infection. This could be due to the pre-transplant profile of patients, who, as indicated in Table 1,…”

Section: Discussionmentioning

confidence: 99%

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Microbiologically documented infections after adult allogeneic hematopoietic cell transplantation: A 5‐year analysis within the Swiss Transplant Cohort study

Dayer

Masouridi‐Levrat

et al. 2020

Transplant Infectious Dis

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Background Infections are an important complication after allogeneic hematopoietic cell transplantation (allo‐HCT). The present study aimed at determining the landscape of infections occurring in a large cohort of allo‐HCT patients, as well as associated risk factors for infections and for one‐year non‐relapse mortality. Methods This is a retrospective cohort study using STCS and EBMT databases to assess the one‐year incidence rate of infection, as well as risk factors for infections and for one‐year non‐relapse mortality among adult allo‐HCT patients transplanted between 2010 and 2014 in Switzerland. Univariable and multivariable quasi‐Poisson and multivariable Cox regression models were used. Results Of 553 patients included, 486 had an infection with a global incidence rate of 3.66 infections per patient‐year. Among a total of 1534 infections analyzed, viral infections were predominant (n = 1138, 74.2%), followed by bacterial (n = 343, 22.4%) and fungal (n = 53, 3.5%) infections. At one year, the cumulative incidence of relapse and non‐relapse mortality was 26% and 16%, respectively. 195 (35.3%) of patients had at least one episode of severe graft‐versus‐host‐disease (GvHD). A center effect was observed, and underlying disease, donor type, cytomegalovirus serological constellation, and GvHD were also associated with the incidence rate of infections. There was an increased risk for one‐year non‐relapse mortality associated with all pathogens, specifically within two months of infection, and this remained true beyond 2 months of a fungal infection. Conclusion Despite advances to limit infections in this population, they still occur in most allo‐HCT patients with a major impact on survival at 1 year.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Microbiologically documented infections after adult allogeneic hematopoietic cell transplantation: A 5‐year analysis within the Swiss Transplant Cohort study

Dayer

Masouridi‐Levrat

et al. 2020

Transplant Infectious Dis

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“…Children in the period of neutropenia were on a low-bacterial diet and kept under strengthened hygiene processes. There was no specific BKV prophylaxis; patients were monitored weekly [ 7 , 11 ].…”

Section: Methodsmentioning

confidence: 99%

Viral Infection Profile in Children Treated for Acute Lymphoblastic Leukemia—Results of Nationwide Study

et al. 2022

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Viral infections can be a serious complication of therapy in children with acute lymphoblastic leukemia (ALL). In this study, we focused on the incidence and the profile of viral infection in children with ALL treated in 17 pediatric oncology centers in Poland in the two-year periods of 2018–2019 and 2020–2021. We also compared the frequency of viral infections in 2018–2019 to that in 2020–2021. In 2020–2021, a total of 192 children with ALL had a viral infection during intensive chemotherapy. A total number of 312 episodes of viral infections were diagnosed. The most common infections detected in the samples were: COVID-19 (23%), rhinovirus (18%), and respiratory syncytial virus (14%). COVID-19 and BK virus infections were the reason for the death 1% of all patients. In 2018–2019, a total of 53 ALL patients who had a viral infection were reported and 72 viral events were observed, mainly adenovirus (48.6%), rotavirus (31.9%), and herpes zoster (8.3%). No deaths were reported during this period. The cumulative incidence of viral infections in 2018–2019 was 10.4%, while for 2020–2021, it was 36.7%. In conclusion, a high incidence of COVID-19 infection was observed among pediatric patients with ALL in Poland. The mortality rate in our material was low. The viral profile in ALL children undergoing chemotherapy can be useful for clinicians to improve prophylactic and therapeutic strategies.

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“…In that respect, a retrospective cohort study performed in the US identified 666 pediatric cases of invasive aspergillosis among 152,231 immunocompromised children and demonstrated that the fungal disease significantly prolonged the length of hospital stay and per-patient hospital charges but also significantly increased in-house mortality [4]. A recent analysis of children with acute lymphoblastic leukemia (ALL) revealed that the rate of infection-related death of 2.4% was mainly due to IFD [5]. In this study, proven IFDs were caused mostly by Candida spp.…”

Section: Introductionmentioning

confidence: 99%

Antifungal Combination Therapy in Children with Cancer—A 4-Year Analysis of Real-Life Data of Two Major Pediatric Cancer Centers

Schöning

Bochennek

Gordon

et al. 2021

JoF

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Clinical data on antifungal combination therapy are limited, in particular in the pediatric setting. We analyzed real-life data collected in two major pediatric cancer centers over a period of 4 years. Patients were identified in an observational study on children with acute leukemia and lymphoma or undergoing hematopoietic cell transplantation. Out of 438 patients, 19 patients received 21 episodes of antifungal combination therapy. Therapy was mostly started for sepsis (n = 5) or clinical deterioration with pulmonary infiltrates (n = 10), and less often for periorbital swelling with suspected mold infection (n = 2), clinical deterioration and new skin lesions, secondary antifungal prophylaxis, a persistently elevated galactomannan index, or as pre-emptive treatment (n = 1 each). Diagnostics revealed proven, probable, and possible invasive fungal disease in two, seven and four episodes, respectively. Most regimens included caspofungin (n = 19), and treatment was initiated as first line therapy in 10 episodes. The median duration was 13 days (4–46 days). Nine of the 13 patients with proven, probable, or possible invasive fungal disease survived, which was comparable to patients receiving antifungal monotherapy. Our analysis demonstrates that combination therapy has mainly been prescribed in selected immunocompromised patients with clinical deterioration due to suspected invasive fungal disease or those with sepsis, and is well tolerated. Future studies need to better characterize clinical settings in which patients may benefit from antifungal combination therapy.

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Infectious profile in children with ALL during chemotherapy: A report of study group for infections

Cited by 17 publications

References 15 publications

Microbiologically documented infections after adult allogeneic hematopoietic cell transplantation: A 5‐year analysis within the Swiss Transplant Cohort study

Microbiologically documented infections after adult allogeneic hematopoietic cell transplantation: A 5‐year analysis within the Swiss Transplant Cohort study

Viral Infection Profile in Children Treated for Acute Lymphoblastic Leukemia—Results of Nationwide Study

Antifungal Combination Therapy in Children with Cancer—A 4-Year Analysis of Real-Life Data of Two Major Pediatric Cancer Centers

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