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Paramyxoviruses for Tumor-targeted Immunomodulation: Design and Evaluation Ex Vivo
Published on: January 7, 2019
Viral infections in pediatric brain tumor patients treated with targeted therapies
Lisa Mayr1, Tobias Steinmaurer1, Lukas Weseslindtner2
1Department of Pediatrics and Adolescent Medicine, Comprehensive Cancer Center for Pediatrics, Medical University of Vienna, Vienna, Austria.
Background:
Brain tumors are the most common solid malignancies and the leading cause of cancer-related mortality in children. While numerous studies report on viral infections in children with hematologic malignancies and solid organ transplantation, epidemiologic data on the incidence and outcome of viral infections in pediatric patients with brain tumors treated with targeted therapies are still lacking.
Objectives/Study Design:
We retrospectively reviewed all children with brain tumors receiving targeted therapies in a primary or recurrent setting at the Medical University of Vienna from 2006 to 2021. Demographic variables, quantitative and qualitative parameters of possible infections, and treatment outcomes were recorded.
Results:
In our cohort (n = 117), 36% of the patients developed at least one PCR-proven viral infection. Respiratory and gastrointestinal tract infections were most common, with 31% and 25%, respectively. Central nervous system (CNS) infections occurred in approximately 10%, with an almost equal distribution of varicella-zoster virus, John Cunningham virus (JCV), and enterovirus. Two patients tested PCR-positive for SARS-CoV-2 infection, with one virus-related death caused by a SARS-CoV-2-related acute respiratory distress syndrome. Patients receiving bevacizumab or mTOR inhibitors seem to have a greater susceptibility to viral infections.
Conclusion:
Pediatric patients with brain tumors receiving targeted therapies have a higher risk of viral infections when compared to children receiving conventional chemotherapy or the general population, and life-threatening infections can occur. Fast detection and upfront treatment are paramount to prevent life-threatening infections in immunocompromised children suffering from brain tumors receiving targeted therapies.
Insights
Pediatric brain tumor patients on targeted therapies face a higher risk of viral infections, including respiratory, gastrointestinal, and CNS types. Early detection and treatment are crucial for better outcomes in these immunocompromised children.
Area of Science:
- Pediatric Oncology
- Infectious Diseases
- Molecular Diagnostics
Background:
- Brain tumors are the leading cause of cancer mortality in children.
- Limited data exists on viral infections in pediatric brain tumor patients on targeted therapies.
- Existing research often focuses on hematologic malignancies or solid organ transplant recipients.
Purpose of the Study:
- To investigate the incidence and outcomes of viral infections in pediatric brain tumor patients receiving targeted therapies.
- To identify specific types of viral infections and risk factors.
- To compare infection rates with conventional chemotherapy and the general population.
Main Methods:
- Retrospective review of pediatric patients with brain tumors treated with targeted therapies (2006-2021).
- Data collection included demographics, infection parameters (PCR-proven), and treatment outcomes.
- Analysis of respiratory, gastrointestinal, CNS, and other viral infections.
Main Results:
- 36% of the 117 patients developed at least one PCR-proven viral infection.
- Respiratory (31%) and gastrointestinal (25%) infections were most common.
- Central nervous system (CNS) infections occurred in ~10% (varicella-zoster virus, John Cunningham virus, enterovirus); SARS-CoV-2 identified in 2 patients, one resulting in death.
Conclusions:
- Pediatric brain tumor patients on targeted therapies exhibit increased susceptibility to viral infections.
- Bevacizumab or mTOR inhibitors may be associated with higher infection risk.
- Prompt detection and treatment are essential to prevent severe outcomes in immunocompromised pediatric patients.
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