Virus infections in children with acute lymphoblastic leukaemia.

Craft, Alan; Reid, M M; Gardner, P. S.; Jackson, Eddie; Kernahan, J.; McQuillin, Joyce; Noble, Timothy; Walker, William B.

doi:10.1136/adc.54.10.755

Cited by 43 publications

(14 citation statements)

References 15 publications

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“…Children with immunodeficiency diseases or onimmunosuppressive therapy suffer severe symptoms, prolonged RSV excretion and occasional extrapulmonary dissemination of virus (55,79,109). A peribronchiolar and perivascular infiltration of lymphocytes has been observed in the lungs of infants with fatal RSV disease.…”

Section: Cell-mediated Immunity (Cmi)mentioning

confidence: 99%

Respiratory syncytial virus

Stott¹,

Taylor²

1985

Archives of Virology

211

125

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Section: Cell-mediated Immunity (Cmi)mentioning

confidence: 99%

Respiratory syncytial virus

Stott¹,

Taylor²

1985

Archives of Virology

211

125

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“…In a study of children with acute lymphoblastic leukemia, 20 of 99 (20%) patients had multiple viruses isolated from the same specimen (5); significantly, only 20 of 796 (2.5%) control patients (no malignant disease or immunosuppressive therapy) had similar mixed infections (5,12). When HSV was excluded, only three mixed infections were identified in healthy children.…”

Section: Mixed Viral Infections In Immunodeficient Patientsmentioning

confidence: 99%

“…The increased incidence may be attributable to the underlying condition of the patients. Immunocompromised patients excrete virus longer than immunocompetent patients (12,21,34,47). Latent viruses, such as HSVs and CMV, are commonly reactivated and may produce chronic infections (40,108,109).…”

Section: Mixed Viral Infections In Immunodeficient Patientsmentioning

confidence: 99%

Mixed viral infections: detection and management

Waner

1994

Clin Microbiol Rev

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An analysis was done of the incidence and nature of mixed virus infections diagnosed in the same clinical specimen from immunocompetent patients; respiratory viruses were emphasized. Few studies have addressed mixed viral infections in any systematic fashion. The relevant studies reviewed focused on clinical relationships or diagnostic methods. Data relating to multiple infections were usually derived incidentally to the purpose of the investigations. Sixty-three percent of the reports with data on mixed infections identified them in < 5% of the total number of viral infections. Respiratory syncytial virus was the most common coinfecting virus, and respiratory syncytial virus and influenza virus were the most common virus pair identified. In considering rapid diagnostic techniques, in 87% of the reports with available data a virus was diagnosed in > 10% of specimens that were negative for the virus targeted by one method. There was no indication that mixed infections were associated with increased disease in immunocompetent patients or in certain immunocompromised patients. Immunocompromised patients, however, appeared to have a greater incidence of multiple infections. Mixed infections of single cells also occur and may have important clinical implications relative to reactivation of latent viruses and enhanced disease. The requirement for a comprehensive strategy for viral diagnosis involving multiple techniques was indicated by these findings.

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“…16 Severe RSV infection has been described as more likely in children with cancer who were receiving immunosuppressive chemotherapy. 6,[17][18][19][20] Although neutropenia has not been conclusively established to be an independent risk factor for the development of LRTI or for RSV-related mortality, it may be considered to play a role in the development of coinfections, especially bacterial infections, which may contribute to higher morbidity and mortality. In contrast, more than half of our patients were admitted because of RSV infection with a median length of stay for patients with LRTI of 6 days, which is shorter than that reported in other studies (7 to 19 d).…”

Section: Discussionmentioning

confidence: 97%

Respiratory Syncytial Virus Infections in Children With Cancer

Chemaly¹,

Ghantoji²,

Shah³

et al. 2014

Journal of Pediatric Hematology/Oncology

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Respiratory syncytial virus (RSV) is a major cause of lower respiratory tract infections (LRTIs) in children, especially those with cancer. Data on RSV infections in this vulnerable population is limited. We conducted a retrospective study of all RSV infections in children with cancer from 1998 to 2009 to determine characteristics and outcomes of these infections, identify risk factors for LRTI and mortality, and the effect of antiviral therapy on these outcomes. We identified 59 patients with a median age of 5 years; 53% had hematologic malignancy, 32% were hematopoietic stem cell transplant recipients, 39% had received corticosteroids, and 76% cytotoxic chemotherapy within 1 month before RSV infection. LRTI developed in 22 (37%) patients with a trend of higher rate in males (odds ratio=2.57 [0.86-7.62], P=0.09) and children with lymphocytopenia (odds ratio=2.95 [0.86-10.12], P=0.085). No significant differences were observed in the rates of progression to LRTI (3/10 [30%] vs. 19/49 [39%], P=0.729) and RSV-associated mortality (0/10 [0%] vs. 3/49 [6%], P=0.422) for patients receiving antiviral therapy at upper respiratory tract infection stage compared with those who did not. However, patients with LRTI had significantly better outcomes when treated with aerosolized ribavirin plus immunomodulators (mainly palivizumab) when compared with aerosolized ribavirin alone (mortality rates: 0/6 [0%] vs. 3/4 [75%], P=0.03). Ribavirin did not show any benefit in reducing LRTI or mortality; however, addition of palivizumab to the treatment regimen may be potentially beneficial, especially for children with LRTI.

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Virus infections in children with acute lymphoblastic leukaemia.

Cited by 43 publications

References 15 publications

Respiratory syncytial virus

Respiratory syncytial virus

Mixed viral infections: detection and management

Respiratory Syncytial Virus Infections in Children With Cancer

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