[Respiratory virus infections in children with acute lymphoblastic leukemia and febrile neutropenia: a prospective study]
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Updated: Aug 8, 2026
An In vitro Model to Study Immune Responses of Human Peripheral Blood Mononuclear Cells to Human Respiratory Syncytial Virus Infection
Published on: December 10, 2013
Marlis Täger F1, Paola Zolezzi R, Isabel Folatre B
1Instituto de Pediatría, Facultad de Medicina, Universidad Austral de Chile, Chile. mtager@uach.cl
Insights
Respiratory viruses are frequently detected in children with acute lymphoblastic leukemia (ALL) during febrile neutropenia. This highlights the need for prompt respiratory virus testing in these vulnerable pediatric cancer patients, especially during colder months.
Area of Science:
- Pediatric Oncology
- Infectious Diseases
- Virology
Context:
- Respiratory viruses are common in children but underrecognized in pediatric cancer patients.
- Chile has limited data on the impact of respiratory viruses in children with acute lymphoblastic leukemia (ALL).
Purpose:
- To determine the frequency and clinical profile of respiratory virus infections in pediatric ALL patients hospitalized with febrile neutropenia.
- To assess the role of specific viruses like influenza, parainfluenza, RSV, and adenovirus.
Summary:
- Respiratory viruses were identified in 25% of febrile neutropenia episodes in children under 15 with ALL.
- Influenza, parainfluenza, and RSV were the most common viruses detected, with some cases being nosocomial.
- Lower respiratory tract involvement and one fatality underscore the severity of these infections.
Impact:
- The high detection rate supports routine respiratory virus diagnostics for febrile neutropenic pediatric ALL patients.
- Early identification of respiratory viruses can guide treatment and improve outcomes in immunocompromised children.
- Findings emphasize the importance of infection control measures in pediatric oncology settings.
Unlabelled:
Respiratory viruses are the most common infections in healthy children. The impact of these infections in cancer patients has been only recently recognized in Chile.
Aim:
To establish the frequency and epidemiological-clinical profile of respiratory virus infections in children younger than 15 years of age with acute lymphoblastic leukemia requiring hospitalization due to a febrile neutropenic episode.
Methods:
All children < 15 years of age requiring hospitalization in the Regional Hospital of Valdivia, Chile, with cancer, fever and neutropenia between November 1 2002 and October 31 2004 were studied. Nasopharyngeal aspirate were obtained and tested by direct immunofluorescent assays for influenza A-B virus, parainfluenza virus type 1, 2, 3, respiratory syncytial virus (RSV) and adenovirus.
Results:
Respiratory viruses were detected in 25% of 44 febrile neutropenia episodes occurring in 25 patients. Viruses detected were, influenza (3/11), parainfluenza (3/11) RSV (2/11), adenovirus (1/11), parainfluenza + RSV (1/11), and parainfluenza + adenovirus (1/11). Four (36%) of cases were nosocomial. Respiratory symptoms were present in 9 children, seven of whom had inferior respiratory tract symptoms. One patient died of persistent RSV infection, agranulocytosis and extensive bilateral pneumonia.
Conclusions:
Respiratory viruses were detected in 25% of febrile neutropenic episodes in children with ALL. This high detection rate together with the frequent involvement of the lower respiratory tract and the possibility of death strongly favors the inclusion of respiratory virus diagnostic tests in the evaluation of these children during autumn and winter season.
