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Varicella zoster infections in children with acute lymphoblastic leukemia
A Poulsen1, K Schmiegelow, M Yssing
1Section of Pediatric Hematology and Oncology, Juliane Marie Centre, University Hospital, Copenhagen, Denmark.
Insights
Children with acute lymphoblastic leukemia face significant varicella zoster virus risk. Vaccination is recommended to reduce chickenpox and shingles complications during cancer treatment.
Area of Science:
- Pediatric Oncology
- Infectious Diseases
- Hematology
Background:
- Children undergoing treatment for non-B-cell acute lymphoblastic leukemia (ALL) are susceptible to infections.
- Varicella zoster (VZ) virus poses a significant risk to immunocompromised pediatric patients.
Purpose of the Study:
- To assess the risk of VZ virus exposure and infection in children with non-B-cell ALL.
- To evaluate the incidence of varicella and herpes zoster during antileukemic therapy.
Main Methods:
- Retrospective analysis of 67 children treated for non-B-cell ALL between July 1986 and December 1991.
- Tracking VZ virus susceptibility, exposure, and infection incidence.
Main Results:
- 90% cumulative VZ exposure risk within 32 months for susceptible children.
- Five patients developed varicella, two with pneumonitis, despite acyclovir prophylaxis.
- 2-year cumulative risk of chickenpox and herpes zoster was 24% and 34% respectively in previously infected children.
Conclusions:
- Children with non-B-cell ALL have a high risk of VZ virus infection.
- VZ vaccination should be considered to reduce morbidity and transmission in this vulnerable population.
Abstract:
During the period July 1986 through December 1991, 67 children were treated for non-B-cell acute lymphoblastic leukemia at The Juliane Marie Centre, GGK, The University Hospital Rigshospitalet, Copenhagen. Twenty-five children were susceptible to varicella zoster (VZ) virus at diagnosis. For these patients the cumulated risk of VZ exposure was 90% after 32 months. Five patients developed varicella (two of whom had pneumonitis) during the period of antileukemic treatment. Two of these had received prophylactic treatment with acyclovir. The 2 year cumulated risk of having chickenpox or herpes zoster in children with previous VZ infection was 24% and 34%, respectively. VZ vaccination ought to be considered for this group of children in order to diminish transmission and morbidity.