tetano
Editor, Senior Moderator
J Hematol Oncol
. 2021 Oct 11;14(1):163.
doi: 10.1186/s13045-021-01181-4.
COVID-19 in pediatric cancer patients is associated with treatment interruptions but not with short-term mortality: a Polish national study
Jadwiga Węcławek-Tompol[SUP] 1 [/SUP], Zuzanna Zakrzewska[SUP] 2 [/SUP], Olga Gryniewicz-Kwiatkowska[SUP] 3 [/SUP], Filip Pierlejewski[SUP] 4 [/SUP], Ewa Bień[SUP] 5 [/SUP], Agnieszka Zaucha-Prażmo[SUP] 6 [/SUP], Olga Zając-Spychała[SUP] 7 [/SUP], Anna Szmydki-Baran[SUP] 8 [/SUP], Agnieszka Mizia-Malarz[SUP] 9 [/SUP], Wioletta Bal[SUP] 10 11 [/SUP], Małgorzata Sawicka-Żukowska[SUP] 12 [/SUP], Agnieszka Kruk[SUP] 13 [/SUP], Anna Raciborska[SUP] 14 [/SUP], Agnieszka Książek[SUP] 15 [/SUP], Tomasz Szczepański[SUP] 15 [/SUP], Jarosław Peregud-Pogorzelski[SUP] 13 [/SUP], Maryna Krawczuk-Rybak[SUP] 12 [/SUP], Radosław Chaber[SUP] 10 11 [/SUP], Michał Matysiak[SUP] 8 [/SUP], Jacek Wachowiak[SUP] 7 [/SUP], Wojciech Młynarski[SUP] 4 [/SUP], Bożenna Dembowska-Bagińska[SUP] 3 [/SUP], Walentyna Balwierz[SUP] 2 [/SUP], Agnieszka Matkowska-Kocjan[SUP] 16 [/SUP], Bernarda Kazanowska[SUP] 1 [/SUP], Jan Styczyński[SUP] 17 [/SUP], Marek Ussowicz[SUP] 18 [/SUP]
Affiliations
Abstract
Background: Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) currently constitutes the leading and overwhelming health issue worldwide. In comparison with adults, children present milder symptoms, with most having an asymptomatic course. We hypothesized that COVID-19 infection has a negative impact on the continuation of chemotherapy and increases nonrelapse mortality.
Material and methods: This study was performed to assess the course of SARS-CoV-2 among children with hematological or oncological malignancies and its impact on cancer therapy. Records of SARS-CoV-2 infection in 155 children with malignancies from 14 Polish centers for pediatric hematology and oncology were collected and analyzed.
Results: SARS-CoV-2 replication was observed in 155 patients. Forty-nine patients were symptomatic, with the following being the most common manifestations: fever (31 patients), gastrointestinal symptoms (10), coryza (13), cough (13) and headache (8). In children who were retested, the median time of a positive PCR result was 16 days (range 1-70 days), but 12.7% of patients were positive beyond day + 20. The length of viral PCR positivity correlated with the absolute neutrophil count at diagnosis. Seventy-six patients did not undergo further SARS-CoV-2 testing and were considered convalescents after completion of isolation. Antibiotic therapy was administered in 15 children, remdesivir in 6, convalescent plasma in 4, oxygen therapy in 3 (1-mechanical ventilation), steroids in 2, intravenous immunoglobulins in 2, and heparin in 4. Eighty patients were treated with chemotherapy within 30 days after SARS-CoV-2 infection diagnosis or were diagnosed with SARS-CoV-2 infection during 30 days of chemotherapy administration. Respiratory symptoms associated with COVID-19 and associated with oxygen therapy were present in 4 patients in the study population, and four deaths were recorded (2 due to COVID-19 and 2 due to progressive malignancy). The probability of 100-day overall survival was 97.3% (95% CI 92.9-99%). Delay in the next chemotherapy cycle occurred in 91 of 156 cases, with a median of 14 days (range 2-105 days).
Conclusions: For the majority of pediatric cancer patients, SARS-CoV-2 infection does not result in a severe, life-threatening course. Our data show that interruptions in therapy are common and can result in suboptimal therapy.
Keywords: COVID-19; Chemotherapy; Pediatric; SARS-CoV-2.
. 2021 Oct 11;14(1):163.
doi: 10.1186/s13045-021-01181-4.
COVID-19 in pediatric cancer patients is associated with treatment interruptions but not with short-term mortality: a Polish national study
Jadwiga Węcławek-Tompol[SUP] 1 [/SUP], Zuzanna Zakrzewska[SUP] 2 [/SUP], Olga Gryniewicz-Kwiatkowska[SUP] 3 [/SUP], Filip Pierlejewski[SUP] 4 [/SUP], Ewa Bień[SUP] 5 [/SUP], Agnieszka Zaucha-Prażmo[SUP] 6 [/SUP], Olga Zając-Spychała[SUP] 7 [/SUP], Anna Szmydki-Baran[SUP] 8 [/SUP], Agnieszka Mizia-Malarz[SUP] 9 [/SUP], Wioletta Bal[SUP] 10 11 [/SUP], Małgorzata Sawicka-Żukowska[SUP] 12 [/SUP], Agnieszka Kruk[SUP] 13 [/SUP], Anna Raciborska[SUP] 14 [/SUP], Agnieszka Książek[SUP] 15 [/SUP], Tomasz Szczepański[SUP] 15 [/SUP], Jarosław Peregud-Pogorzelski[SUP] 13 [/SUP], Maryna Krawczuk-Rybak[SUP] 12 [/SUP], Radosław Chaber[SUP] 10 11 [/SUP], Michał Matysiak[SUP] 8 [/SUP], Jacek Wachowiak[SUP] 7 [/SUP], Wojciech Młynarski[SUP] 4 [/SUP], Bożenna Dembowska-Bagińska[SUP] 3 [/SUP], Walentyna Balwierz[SUP] 2 [/SUP], Agnieszka Matkowska-Kocjan[SUP] 16 [/SUP], Bernarda Kazanowska[SUP] 1 [/SUP], Jan Styczyński[SUP] 17 [/SUP], Marek Ussowicz[SUP] 18 [/SUP]
Affiliations
- PMID: 34635137
- DOI: 10.1186/s13045-021-01181-4
Abstract
Background: Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) currently constitutes the leading and overwhelming health issue worldwide. In comparison with adults, children present milder symptoms, with most having an asymptomatic course. We hypothesized that COVID-19 infection has a negative impact on the continuation of chemotherapy and increases nonrelapse mortality.
Material and methods: This study was performed to assess the course of SARS-CoV-2 among children with hematological or oncological malignancies and its impact on cancer therapy. Records of SARS-CoV-2 infection in 155 children with malignancies from 14 Polish centers for pediatric hematology and oncology were collected and analyzed.
Results: SARS-CoV-2 replication was observed in 155 patients. Forty-nine patients were symptomatic, with the following being the most common manifestations: fever (31 patients), gastrointestinal symptoms (10), coryza (13), cough (13) and headache (8). In children who were retested, the median time of a positive PCR result was 16 days (range 1-70 days), but 12.7% of patients were positive beyond day + 20. The length of viral PCR positivity correlated with the absolute neutrophil count at diagnosis. Seventy-six patients did not undergo further SARS-CoV-2 testing and were considered convalescents after completion of isolation. Antibiotic therapy was administered in 15 children, remdesivir in 6, convalescent plasma in 4, oxygen therapy in 3 (1-mechanical ventilation), steroids in 2, intravenous immunoglobulins in 2, and heparin in 4. Eighty patients were treated with chemotherapy within 30 days after SARS-CoV-2 infection diagnosis or were diagnosed with SARS-CoV-2 infection during 30 days of chemotherapy administration. Respiratory symptoms associated with COVID-19 and associated with oxygen therapy were present in 4 patients in the study population, and four deaths were recorded (2 due to COVID-19 and 2 due to progressive malignancy). The probability of 100-day overall survival was 97.3% (95% CI 92.9-99%). Delay in the next chemotherapy cycle occurred in 91 of 156 cases, with a median of 14 days (range 2-105 days).
Conclusions: For the majority of pediatric cancer patients, SARS-CoV-2 infection does not result in a severe, life-threatening course. Our data show that interruptions in therapy are common and can result in suboptimal therapy.
Keywords: COVID-19; Chemotherapy; Pediatric; SARS-CoV-2.