Related Experiment Video
Updated: Dec 3, 2025
Murine Model of Leukemia Relapse to Induction Chemotherapy for Acute Lymphoblastic Leukemia
Published on: October 17, 2025
Diagnostic difficulties of AH1N1 influenza infection in children with acute lymphoblastic leukemia: Two case reports
Joanna Zawitkowska1, Monika Lejman1,2, Katarzyna Drabko1
1Department of Paediatric Haematology, Oncology, and Transplantology, Medical University.
Insights
Children with acute lymphoblastic leukemia (ALL) face severe influenza risks. Early antiviral treatment and vaccination are crucial for managing swine-origin influenza A in high-risk pediatric cancer patients, as two cases tragically illustrate.
Area of Science:
- Pediatric Oncology
- Infectious Diseases
- Hematology
Background:
- Children with acute lymphoblastic leukemia (ALL) have a heightened risk of severe influenza complications.
- Influenza infection in pediatric cancer patients can necessitate intensive care and lead to mortality.
Observation:
- Two cases of children with ALL experiencing swine-origin influenza A virus infection are presented.
- Diagnosis was challenging due to initial negative swine-origin influenza A polymerase chain reaction tests, delaying treatment.
- Both patients developed pneumonia and other complications, requiring chemotherapy interruption.
Findings:
- Despite interventions including oseltamivir, broad-spectrum antibiotics, antifungals, and growth factors, both patients experienced rapid disease progression.
- The cases highlight the diagnostic difficulties and rapid, fatal progression of influenza in immunocompromised pediatric cancer patients.
Implications:
- Early diagnosis and prompt antiviral therapy are critical for improving outcomes in high-risk pediatric ALL patients with influenza.
- Vaccination of family members, empiric treatment, and parental education on hygiene are vital strategies to minimize influenza-related morbidity and mortality.
Introduction:
Children with acute lymphoblastic leukemia (ALL) are at a risk of developing influenza-related complications. Approximately 10% of influenza-infected children with ALL or other types of cancer need intensive care, and 5% of them eventually die.
Patients' Concerns:
We report 2 children with ALL and the swine-origin influenza A virus infection. Diagnosing influenza in them was a challenge. Medical records of these children were reviewed for demographic, clinical, and laboratory data. Patients were hospitalized in the Department of Pediatric Hematology, Oncology, and Transplantology of the Medical University of Lublin, Poland. Case 1 involved a 2-year-old girl who, according to acute lymphoblastic leukemia intercontinental Berlin-Frankfürt-Münster protocol 2009, started chemotherapy in July 2015. She was categorized in the intermediate risk group and received the induction and consolidation phase of the therapy without severe complications. The reinduction therapy was administered in the outpatient department till the 15 day. On the 20 day of this phase, she was admitted to our department with fever, mucositis, tachypnea, abdominal pain, and diarrhea. In September 2009, a 14-year-old boy (case 2) who, according to acute lymphoblastic leukemia intercontinental Berlin-Frankfürt-Münster protocol 2002, was categorized in the high-risk (HR) group, received the induction (Protocol I) phase of therapy without severe complications. On the 7 day of the HR-1 course, he manifested fever and strong, tiring cough, followed by strong mucositis. Chemotherapy had to be interrupted in both children.
Diagnosis:
Respiratory viral infections, causing pneumonia, occurred in both patients during anticancer treatment. Initially, the real-time polymerase chain reaction test for the swine-origin influenza A was negative in both patients, which delayed the diagnosis. Additionally, bacterial, and fungal complications were also observed.
Interventions:
Both patients received oseltamivir twice a day, a broad-spectrum antibiotic, antifungal drug, and granulocyte colony growth factor.
Outcomes:
The disease progressed quickly, and our patients subsequently died.
Conclusion:
We speculated that early antiviral treatment can help in the better management of patients in the HR group. It is also important to minimize influenza morbidity and mortality by vaccinating family members, using empiric therapy, providing immediate antiviral therapy, and educating parents about hygiene measures.
More Related Videos
08:01Detection of Invasive Pulmonary Aspergillosis in Haematological Malignancy Patients by using Lateral-flow Technology
Published on: March 22, 2012
09:57Comprehensive Protocol to Sample and Process Bone Marrow for Measuring Measurable Residual Disease and Leukemic Stem Cells in Acute Myeloid Leukemia
Published on: March 5, 2018