COVID-19 Disease in Children With ALL Receiving Maintenance Therapy: Do Not Discount the Risk.

Area of Science:

• Pediatric Oncology
• Infectious Diseases
• Hematology/Oncology

Background:

• Children with acute lymphoblastic leukemia (ALL) in maintenance therapy (ALL-MTN) often resume normal activities, necessitating understanding of COVID-19's impact.
• Physicians require data on persistent COVID-19 effects in pediatric cancer patients to guide families post-pandemic.

Purpose of the Study:

• To compare the clinical course of COVID-19 in children with ALL-MTN versus other pediatric cancer patients.
• To identify factors influencing COVID-19 outcomes in pediatric cancer.

Main Methods:

• Data collected from the Pediatric Oncology COVID-19 Case Report (POCC) database, including sociodemographics and clinical information.
• Analysis compared 481 children with ALL-MTN to 1,190 other pediatric cancer patients with COVID-19.
• Multivariable analyses adjusted for age, race, insurance, neutrophil count, vaccination status, and comorbidities.

Main Results:

• Children with ALL-MTN experienced significantly fewer hospitalizations (23% vs. 29%) and ICU admissions (3% vs. 5%) compared to other pediatric cancer patients.
• However, cancer-directed therapy modifications were more frequent in the ALL-MTN group (50% vs. 33%).
• COVID-19 vaccination was an independent factor, reducing hospitalization odds (OR, 0.7).

Conclusions:

• Pediatric patients with ALL-MTN had a less severe clinical course regarding hospitalization and ICU admission but required more frequent treatment adjustments.
• COVID-19 vaccination demonstrated a protective effect, decreasing the likelihood of hospitalization in this cohort.