Pulmonary Infectious Complications in Children with Hematologic Malignancies and Chemotherapy-Induced Neutropenia

Voulgaridou, Aikaterini; Athanasiadou, Kleoniki I.; Athanasiadou, E; Roilides, Emmanuel; Παπακωνσταντίνου, Ευγενία

doi:10.3390/diseases8030032

Cited by 9 publications

(12 citation statements)

References 49 publications

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“…Immunocompromised children are at risk of pneumonia due to opportunistic pathogens, especially prolonged corticosteroid therapy was found to be a risk factor in pneumocystis pneumonia in pediatric patients 38 . Chemotherapy, which causes bone marrow insufficiency, is also a principal factor in causing pneumonia in pediatric patients 39 . In our study, intensive systemic treatment was not found to be statistically related to pneumonia in pediatric patients, but all pediatric patients diagnosed with pneumonia had received systemic treatment for more than 2 months.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary toxicity of craniospinal irradiation using helical tomotherapy

Lee

Kim

et al. 2022

Sci Rep

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Craniospinal irradiation using helical tomotherapy (HT-CSI) has advantages in aspects of homogeneous dose distribution. Physicians, however, still have concerns of pulmonary toxicity due to HT-CSI’s relatively large, low-dose irradiated volume from continuous and 360° rotation delivery. In this study, we investigated the pulmonary toxicity of HT-CSI. We retrospectively reviewed 105 patients who received HT-CSI between January 2014 and December 2019. Grade 2 + pulmonary toxicities were evaluated. Intensive systemic treatment was defined as systemic treatment administration before, during, and after HT-CSI. VX Gy was defined as % volume receiving ≥ X Gy. Thirteen patients (12.4%) presented with grade 2 + pulmonary toxicities after HT-CSI. Of these patients, only one experienced grade 2 radiation pneumonitis combined with pembrolizumab-induced pneumonitis. Conversely, pneumonia was observed in 12 patients. Intensive systemic treatment (p = 0.004), immunosuppressive drugs (p = 0.031), and bilateral lung V5 Gy ≥ 65% (p = 0.031) were identified as independent risk factors for pneumonia. The risk factor for pneumonia in pediatric patients were immunosuppressive drugs (p = 0.035) and bilateral lung V5 Gy ≥ 65% (p = 0.047). HT-CSI can be a safe treatment modality with tolerable pulmonary toxicities. Intensive systemic treatment, immunosuppressive drugs, and bilateral lung V5 Gy ≥ 65% were significantly associated with pneumonia. In these patients, close follow-up should be considered for proper management of pneumonia.

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Section: Discussionmentioning

confidence: 99%

Pulmonary toxicity of craniospinal irradiation using helical tomotherapy

Lee

Kim

et al. 2022

Sci Rep

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“…Pulmonary CT examination is strongly recommended. In this study, the imaging of children with pneumonia were mainly characterized by ground glass shadow, consolidation shadow, streak shadow and nodule shadow, which suggested bacterial and/or fungal infection(Nambu et al 2014;Voulgaridou et al 2020).…”

mentioning

confidence: 83%

Clinical Characteristics and Risk Factors of Acute Lymphoblastic Leukemia Children Complicated with Severe Infection during the Maintenance treatment

Yin

Han

Hao

et al. 2022

Preprint

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Purpose Infection is the most common adverse event of acute lymphoblastic leukemia (ALL) treatment and also one of the main causes of death. To investigate the clinical characteristics and risk factors of severe infection during the maintenance phase of ALL treatment, we conducted a retrospective study. Methods We collected clinical data of ALL children, and analyzed the clinical features and risk factors of severe infection by χ2 test and binary Logistic regression. Results A total of 181 children were eligible, and 46 patients (25.4%) suffered from 51 events of severe infection, most of which occurred in the first half year of the maintenance phase (52.9%). The most common infection was pulmonary infection (86.3%) and followed by bloodstream infection (19.6%). The positive rate of pathogen detection was low (17.6%, 44/250), and the most common one was fungal infection. The main symptoms of ALL patients with pulmonary infection were fever, cough and shortness of breath. The main manifestations of CT were ground glass shadow (56.8%), consolidation shadow (27.3%) and streak shadow (25%). Binary logistic regression analysis showed that agranulocytosis, agranulocytosis ≥ 7 days, anemia and low globulin level were independent risk factors for severe infection during the maintenance phase (all P < 0.05). Conclusion Blood routine examinations and protein levels should be monitored regularly for ALL patients in the maintenance phase, especially in the first six months. For ALL patients with the risk factors, preventive anti-infective therapy or supportive therapy can be given as appropriate to reduce the occurrence of severe infection.

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“…ere are no specific case reports or clinical investigations analyzing M. pneumoniae infections in children affected with congenital neutropenia [24,48,49]. Notably, there is no evidence that acquired neutropenia in children with cancer significantly predisposes to M. pneumoniae pneumonia; conversely, recent studies showed a correlation between neutrophil number and extravasation into the lungs with the severity of M. pneumoniae pneumonia in this clinical setting [50,51].…”

Section: Innate Immunity Defectsmentioning

confidence: 99%

“…There are no specific case reports or clinical investigations analyzing M . pneumoniae infections in children affected with congenital neutropenia [ 24 , 48 , 49 ]. Notably, there is no evidence that acquired neutropenia in children with cancer significantly predisposes to M .…”

Section: Innate Immunity Defectsmentioning

confidence: 99%

Mycoplasma pneumoniae Infections and Primary Immune Deficiencies

Poddighe

Demirkaya

Sazonov

et al. 2022

International Journal of Clinical Practice

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Mycoplasma pneumoniae (M. pneumoniae) is one of the leading causes of community-acquired pneumonia in children and is also implicated in a variety of reactive extrapulmonary diseases. Recurrent and/or severe respiratory infections are one of the most frequent manifestations of several types of primary immunodeficiency. Here, we reviewed the medical literature to assess the potential relevance of M. pneumoniae in the infections observed in children affected with combined, humoral, and innate primary immune deficiencies. M. pneumoniae does not result to be epidemiologically prevalent as a cause of pneumonia in children affected by primary immunodeficiencies, but this infection can have a persistent or severe course in this category of patients. Indeed, the active search of M. pneumoniae could be useful and appropriate especially in children with humoral immune deficiencies. Indeed, most cases of M. pneumoniae infection in primary immunodeficiencies are described in patients affected by a/hypo-gammaglobulinemia.

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Pulmonary Infectious Complications in Children with Hematologic Malignancies and Chemotherapy-Induced Neutropenia

Cited by 9 publications

References 49 publications

Pulmonary toxicity of craniospinal irradiation using helical tomotherapy

Pulmonary toxicity of craniospinal irradiation using helical tomotherapy

Clinical Characteristics and Risk Factors of Acute Lymphoblastic Leukemia Children Complicated with Severe Infection during the Maintenance treatment

Mycoplasma pneumoniae Infections and Primary Immune Deficiencies

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