A retrospective study of malaria in pediatric oncology patients in Senegal

We retrospectively studied the outcome of malaria infection in pediatric oncology patients presenting to a single institution in Senegal, West Africa over a 10-year period (2000 to 2009). We investigated whether myelosuppression (secondary to chemotherapy) was associated with increased case fatality from malaria. Anonymized clinical and laboratory data were recorded. Severe anemia was defined as hemoglobin less than 6 g/dL, leucopenia as total white blood cell count less than 4×10⁹/L, neutropenia as less than 1×10⁹/L, and "lymphopenia" as non-neutrophil component less than 2.5×10⁹/L. Primary outcome was death within 1 month of malaria diagnosis, from coma or multiple organ failure, in the absence of another infectious cause. Data analysis was carried out with SPSS (v16.0) using Fisher exact test (P<0.05, significant). Fifty-five malarial cases were confirmed in 54 patients (total 400 patients; overall incidence 14%). Four cases were excluded because of lack of outcome data. Of the remaining 51 episodes, at 1 month after malaria diagnosis, 46 recovered (90.2%) and 5 died (9.8%). There was no association with severe anemia, leucopenia, neutropenia, or lymphopenia (P=1.00, P=0.28, P=0.53, and P=0.22, respectively). Despite the high incidence of myelosuppression in pediatric oncology patients, we found no evidence that this was associated with increased fatality of malaria episodes.