tetano
Editor, Senior Moderator
Pediatr Infect Dis J. 2012 Jul 5. [Epub ahead of print]
Clinical and Demographic Characteristics of Seasonal Influenza in Pediatric Patients with Cancer.
Carr SB, Adderson EE, Hakim H, Xiong X, Yan X, Caniza M.
Source
Departments of 1Infectious Diseases, 5International Outreach Program and 4Biostatistics, St. Jude Children's Research Hospital, Memphis, TN 38105, USA; and the Departments of 2Molecular Sciences and 3Pediatrics, University of Tennessee Health Sciences Center, Memphis, TN 38163, USA. aPresent affiliation: Department of Pediatrics, Division of Pediatric Infectious Diseases, University of South Florida, Tampa, FL. bPresent affiliation: Center for Health Research, Geisinger Health System, Danville, PA.
Abstract
BACKGROUND:
Changes in oncology care and the diagnosis and management of influenza over the past several decades may have altered the epidemiology and outcomes of influenza in pediatric oncology patients.
METHODS:
The clinical features and outcomes of 102 pediatric patients undergoing cancer therapy during 107 episodes of influenza between January 2002 and April 2009 were retrospectively ascertained.
RESULTS:
Median age at the time of influenza was 7.2 years [interquartile range (IQR) 3.8-11.2 years]; 46% of patients were male. Nineteen patients (18%) were recipients of hematopoietic stem cell transplants (HSCT). Patients' median absolute neutrophil and lymphocyte counts were 1300/μL (IQR 500-2967/μL) and 360/μL (IQR 180-836/μL), respectively. Twelve patients (11%) had co-infections with influenza and one or more other respiratory pathogens. Influenza prompted patients' hospitalization during 64% of episodes, and 75% received antiviral therapy. Complications occurred in 30% of infections and serious complications occurred in 7%. Three patients died, but no deaths were directly attributable to influenza. Most patients had delays in cancer therapy; the median delay was 5 days. Neutropenia, concurrent infection, increasing age and having received HSCT increased the risk of serious complications.
CONCLUSIONS:
Advances in the management of pediatric cancer and influenza have not altered the epidemiology and outcome of influenza in oncology patients. Clinical features identify subgroups of patients with influenza who are at risk for poor outcomes and those with a good prognosis.
PMID:
22772169
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/22772169
Clinical and Demographic Characteristics of Seasonal Influenza in Pediatric Patients with Cancer.
Carr SB, Adderson EE, Hakim H, Xiong X, Yan X, Caniza M.
Source
Departments of 1Infectious Diseases, 5International Outreach Program and 4Biostatistics, St. Jude Children's Research Hospital, Memphis, TN 38105, USA; and the Departments of 2Molecular Sciences and 3Pediatrics, University of Tennessee Health Sciences Center, Memphis, TN 38163, USA. aPresent affiliation: Department of Pediatrics, Division of Pediatric Infectious Diseases, University of South Florida, Tampa, FL. bPresent affiliation: Center for Health Research, Geisinger Health System, Danville, PA.
Abstract
BACKGROUND:
Changes in oncology care and the diagnosis and management of influenza over the past several decades may have altered the epidemiology and outcomes of influenza in pediatric oncology patients.
METHODS:
The clinical features and outcomes of 102 pediatric patients undergoing cancer therapy during 107 episodes of influenza between January 2002 and April 2009 were retrospectively ascertained.
RESULTS:
Median age at the time of influenza was 7.2 years [interquartile range (IQR) 3.8-11.2 years]; 46% of patients were male. Nineteen patients (18%) were recipients of hematopoietic stem cell transplants (HSCT). Patients' median absolute neutrophil and lymphocyte counts were 1300/μL (IQR 500-2967/μL) and 360/μL (IQR 180-836/μL), respectively. Twelve patients (11%) had co-infections with influenza and one or more other respiratory pathogens. Influenza prompted patients' hospitalization during 64% of episodes, and 75% received antiviral therapy. Complications occurred in 30% of infections and serious complications occurred in 7%. Three patients died, but no deaths were directly attributable to influenza. Most patients had delays in cancer therapy; the median delay was 5 days. Neutropenia, concurrent infection, increasing age and having received HSCT increased the risk of serious complications.
CONCLUSIONS:
Advances in the management of pediatric cancer and influenza have not altered the epidemiology and outcome of influenza in oncology patients. Clinical features identify subgroups of patients with influenza who are at risk for poor outcomes and those with a good prognosis.
PMID:
22772169
[PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/22772169