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Viral Infection Profile in Children Treated for Acute Lymphoblastic Leukemia-Results of Nationwide Study
Joanna Zawitkowska1, Katarzyna Drabko1, Krzysztof Czyżewski2
1Department of Pediatric Hematology, Oncology and Transplantation, Medical University, 20-059 Lublin, Poland.
Insights
Viral infections, particularly COVID-19, significantly increased in children with acute lymphoblastic leukemia (ALL) in Poland between 2018-2021. This highlights the need for updated prophylactic and therapeutic strategies in pediatric oncology.
Area of Science:
- Pediatric Oncology
- Infectious Diseases
- Hematology
Background:
- Viral infections pose a significant risk to children undergoing intensive chemotherapy for acute lymphoblastic leukemia (ALL).
- Understanding the evolving landscape of viral infections in this vulnerable population is crucial for effective management.
Purpose of the Study:
- To determine the incidence and profile of viral infections in pediatric ALL patients in Poland during 2018-2019 and 2020-2021.
- To compare the frequency of viral infections between these two periods and identify common pathogens.
Main Methods:
- A retrospective study analyzing viral infections in children with ALL treated across 17 Polish pediatric oncology centers.
- Data collection covered two-year periods: 2018-2019 and 2020-2021, focusing on diagnosed viral episodes and patient outcomes.
Main Results:
- The cumulative incidence of viral infections rose from 10.4% in 2018-2019 to 36.7% in 2020-2021.
- In 2020-2021, COVID-19 (23%), rhinovirus (18%), and RSV (14%) were most prevalent. COVID-19 and BK virus caused 1% of deaths.
- In 2018-2019, adenovirus (48.6%) and rotavirus (31.9%) were dominant, with no reported deaths.
Conclusions:
- A notable increase in viral infections, especially COVID-19, occurred in pediatric ALL patients in Poland during the study period.
- The viral infection profile has shifted, emphasizing the need for updated clinical strategies.
- Low mortality rates were observed, but the findings underscore the importance of vigilant monitoring and tailored interventions.
Abstract:
Viral infections can be a serious complication of therapy in children with acute lymphoblastic leukemia (ALL). In this study, we focused on the incidence and the profile of viral infection in children with ALL treated in 17 pediatric oncology centers in Poland in the two-year periods of 2018-2019 and 2020-2021. We also compared the frequency of viral infections in 2018-2019 to that in 2020-2021. In 2020-2021, a total of 192 children with ALL had a viral infection during intensive chemotherapy. A total number of 312 episodes of viral infections were diagnosed. The most common infections detected in the samples were: COVID-19 (23%), rhinovirus (18%), and respiratory syncytial virus (14%). COVID-19 and BK virus infections were the reason for the death 1% of all patients. In 2018-2019, a total of 53 ALL patients who had a viral infection were reported and 72 viral events were observed, mainly adenovirus (48.6%), rotavirus (31.9%), and herpes zoster (8.3%). No deaths were reported during this period. The cumulative incidence of viral infections in 2018-2019 was 10.4%, while for 2020-2021, it was 36.7%. In conclusion, a high incidence of COVID-19 infection was observed among pediatric patients with ALL in Poland. The mortality rate in our material was low. The viral profile in ALL children undergoing chemotherapy can be useful for clinicians to improve prophylactic and therapeutic strategies.
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