Varicella-zoster virus infection in the pediatric population with acute lymphoblastic leukemia in Poland

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Joanna Zawitkowska1, Monika Lejman2, Anna Szmydki-Baran3

  • 1Department of Pediatric Hematology, Oncology and Transplantation, Medical University, Lublin, Poland.

Journal of Medical Virology
|May 15, 2020
PubMed

Insights

Varicella-zoster virus (VZV) infection is infrequent in children with acute lymphoblastic leukemia (ALL). Current therapies effectively manage VZV, with no serious complications observed in pediatric cancer patients.

Area of Science:

  • Pediatric Hematology-Oncology
  • Infectious Diseases
  • Virology

Background:

  • Pediatric patients undergoing hemato-oncology treatment, particularly those with acute lymphoblastic leukemia (ALL), face risks from immunosuppression-related infections like Varicella-zoster virus (VZV).
  • Understanding VZV incidence and outcomes is crucial for optimizing care in this vulnerable population.

Purpose of the Study:

  • To evaluate the incidence, antiviral therapy, and outcomes of VZV infections in children with ALL treated in Polish hemato-oncological centers from 2012 to 2019.

Main Methods:

  • Retrospective analysis of medical records for 1874 pediatric patients (aged 1-18 years) newly diagnosed with ALL.
  • Data collection focused on viral infections, specifically VZV, during chemotherapy, including therapy duration and clinical outcomes.

Main Results:

  • The overall incidence of VZV infection was 1.8% (34 out of 1874 patients).
  • Herpes zoster occurred in 70.6% of cases, and varicella in 29.4%. Infections primarily happened during maintenance, reinduction, and induction chemotherapy phases.
  • No correlation was found between steroid dosage/type and zoster; however, lymphocyte counts were reduced during zoster episodes. All patients survived without serious complications.

Conclusions:

  • A low incidence of VZV infection was observed in pediatric ALL patients in Poland.
  • Current therapeutic strategies appear effective in managing VZV infections in pediatric cancer patients.
  • Preventing chemotherapy delays remains a key focus for patient management.

Keywords:
chemotherapychildhood acute lymphoblastic leukemiavaricella-zoster virus

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