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Differential risk of viral infections in children undergoing complex anticancer therapy or hematopoietic stem cell transplantation
Affiliations- Department of Pediatric Surgery, Collegium Medicum, Nicolaus Copernicus University in Toruń, Jurasz University Hospital, Bydgoszcz, ul. Skłodowskiej-Curie 9, 85-094 Bydgoszcz, Poland
- Collegium Medicum, Nicolaus Copernicus University, University Hospital 1, Bydgoszcz, Poland
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Abstract
Background: Infections constitute a major problem for patients during oncological treatment or undergoing
hematopoietic stem cell transplantation (HCT).
Objective: The aim of the study was to analyze the epidemiology of viral infections in children during anticancer
therapy (PHO, pediatric haematology and oncology) or after HCT over a period of consecutive
6 years in a single-centre study.
Patients and methods: During this period, a total number of 182 HCTs were performed, and 306 children
were newly diagnosed for malignancy. Incidence, hazard risk and outcome of infections were analyzed.
Results: The cumulative incidence of viral infections was 61.7% in allo-HCT, 8.5% in PHO, and 4.1% in
auto-HCT patients. The overall risk of viral infection in HCT patients was 17.3-fold higher (p < 0.0001)
than in PHO patients. The risk was 30-fold higher for CMV and 63-fold higher for EBV, while the risk was
comparable for influenza and adenovirus infection. Infections with polyoma BKV occurred only in HCT
patients after allo-HCT. Factors contributing to increased risk of viral infections in allo-HCT patients both in
uni- and multivariate analysis were: male sex, diagnosis of acute leukemia, alternative donor, CMV positive
serostatus in recipient and/or donor, acute and chronic GVHD. All patients except two allo-HCT children
survived viral infections. The cause of death were influenza and EBV-PTLD.
Conclusions: The risk of viral infections in allo-HCT patients is much higher than in auto-HSCT and PHO
patients, while the outcome of infections was better in the PHO and auto-HCT setting.
Abstract
Background: Infections constitute a major problem for patients during oncological treatment or undergoing
hematopoietic stem cell transplantation (HCT).
Objective: The aim of the study was to analyze the epidemiology of viral infections in children during anticancer
therapy (PHO, pediatric haematology and oncology) or after HCT over a period of consecutive
6 years in a single-centre study.
Patients and methods: During this period, a total number of 182 HCTs were performed, and 306 children
were newly diagnosed for malignancy. Incidence, hazard risk and outcome of infections were analyzed.
Results: The cumulative incidence of viral infections was 61.7% in allo-HCT, 8.5% in PHO, and 4.1% in
auto-HCT patients. The overall risk of viral infection in HCT patients was 17.3-fold higher (p < 0.0001)
than in PHO patients. The risk was 30-fold higher for CMV and 63-fold higher for EBV, while the risk was
comparable for influenza and adenovirus infection. Infections with polyoma BKV occurred only in HCT
patients after allo-HCT. Factors contributing to increased risk of viral infections in allo-HCT patients both in
uni- and multivariate analysis were: male sex, diagnosis of acute leukemia, alternative donor, CMV positive
serostatus in recipient and/or donor, acute and chronic GVHD. All patients except two allo-HCT children
survived viral infections. The cause of death were influenza and EBV-PTLD.
Conclusions: The risk of viral infections in allo-HCT patients is much higher than in auto-HSCT and PHO
patients, while the outcome of infections was better in the PHO and auto-HCT setting.
Keywords
viral infections, malignant diseases, pediatric haematology and oncology, hematopoietic stem cell transplantation, children
About this articleTitle
Differential risk of viral infections in children undergoing complex anticancer therapy or hematopoietic stem cell transplantation
Journal
Issue
Article type
Original article
Pages
127-133
Published online
2018-10-25
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888
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732
DOI
Bibliographic record
Medical Research Journal 2018;3(3):127-133.
Keywords
viral infections
malignant diseases
pediatric haematology and oncology
hematopoietic stem cell transplantation
children
Authors
Przemysław Gałązka
Magdalena Dziedzic
Krzysztof Czyżewski
Jan Styczynski
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