Analysis of Fatal Cases of Pandemic Influenza A (H1N1) Virus Infections in Pediatric Patients with Leukemia

Yaman, Yontem; Devrim, İlker; Oymak, Yeşim; Türedi, Ayşen; Özek, Gülcihan; Cartı, Özgür; Meral, Akçay Ciblak; Burçak, Tatlı Güneş; Bengü, Demirağ; Есин, А П; Badur, Selim; Vergin, Canan

doi:10.3109/08880018.2013.796025

Cited by 12 publications

(9 citation statements)

References 24 publications

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“…Secondary bacterial or fungal pulmonary infection was the most common complication, occurring in those with RSV (7 patients), the 2009 pandemic H1N1 influenza A (2 patients), and RSV‐influenza B coinfection (1 patient) and progressing to multiorgan failure and a fatal outcome in 1 patient. The complicated viral LRTI described in the current study was in agreement with previous studies that evaluated the severity of RSV‐related and influenza‐related clinical courses in immunocompromised children with cancer . It is important to note that despite the seemingly high rate of complications, the mortality rate was 0.7%, which is at the lower end of the pediatric fever and neutropenia‐related mortality range, which has been reported as 0.5% to 6.6% …”

Section: Discussionsupporting

confidence: 90%

“…In their study, 12 of 69 children with leukemia or lymphoma (17%) were reported to develop LRTI, a percentage that was similar to the current study findings of 12% that also included the 2009 pandemic H1N1 influenza A virus. Our experience with 2009 pandemic H1N1 influenza A infection in children with ALL is not different from other reports in oncology patients . Although the majority of immunocompromised patients with 2009 pandemic H1N1 influenza A virus developed a mild course of URTI, a few case reports have described severe morbidity and mortality.…”

Section: Discussioncontrasting

confidence: 60%

“…The complicated viral LRTI described in the current study was in agreement with previous studies that evaluated the severity of RSVrelated and influenza-related clinical courses in immunocompromised children with cancer. 12,[16][17][18] It is important to note that despite the seemingly high rate of complications, the mortality rate was 0.7%, which is at the lower end of the pediatric fever and neutropenia-related mortality range, which has been reported as 0.5% to 6.6%. 21,22 In addition to hospitalization and complications, ARI with viral etiology has markedly impacted the chemotherapy course in children with ALL.…”

Section: Discussionmentioning

confidence: 94%

“…Our experience with 2009 pandemic H1N1 influenza A infection in children with ALL is not different from other reports in oncology patients. [12][13][14][15][16][17] Although the majority of immunocompromised patients with 2009 pandemic H1N1 influenza A virus developed a mild course of URTI, a few case reports have described severe morbidity and mortality. In the current study, no deaths were associated with 2009 pandemic H1N1 influenza A infection in children with ALL.…”

Section: Discussionmentioning

confidence: 99%

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Acute respiratory infections in children and adolescents with acute lymphoblastic leukemia

Hakim

Dallas

Zhou

et al. 2015

Cancer

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Background Knowledge about the incidence, clinical course and impact of respiratory viral infections in children with acute lymphoblastic leukemia (ALL) is limited. Methods A retrospective cohort of patients with newly diagnosed ALL on Total Therapy XVI protocol at St Jude Children’s Research Hospital between 2007 and 2011 was evaluated. Results Of 223 children, 95 (43%) developed 133 episodes of viral acute respiratory illness (ARI) (incidence = 1.1/1,000 patient-days). ARI without viral etiology was identified in 65 (29%) patients and no ARI in 63 (28%). There were no significant associations between race, gender, age, or ALL risk group and development of ARI. Children receiving induction chemotherapy were at the highest risk for viral ARI (incidence, 2.3 per 1,000 patient-days). Influenza virus was the most common virus (38%) followed by respiratory syncytial virus (RSV) (33%). Of 133 episodes of viral ARI, 61% of patients were hospitalized, 26% suffered a complicated course, 80% had their chemotherapy delayed, and 0.7% died. Twenty-four (18%) patients developed viral lower respiratory tract infection (LRTI); of which 5 (21%) had complications. Patients with viral LRTI had significantly lower nadir absolute lymphocyte count, were sicker at presentation, and were more likely to have RSV, to be hospitalized, and to have their chemotherapy delayed for longer time compared to those with viral URTI. Conclusion Despite the low incidence of viral ARI in children with ALL, the associated morbidity, mortality, and delay in chemotherapy remain clinically significant. Viral LRTI was particularly associated with high morbidity requiring intensive care level support.

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Section: Discussionsupporting

confidence: 90%

Section: Discussioncontrasting

confidence: 60%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

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Acute respiratory infections in children and adolescents with acute lymphoblastic leukemia

Hakim

Dallas

Zhou

et al. 2015

Cancer

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“…In our study, 2 out of 8 patients had a fatal course (25%) of which 1 developed pneumonia and acute respiratory distress syndrome, and the other developed HLH and died due to secondary infection in the 6 th week of treatment for HLH. [ 9 ]…”

Section: Discussionmentioning

confidence: 99%

Diagnostic difficulties of AH1N1 influenza infection in children with acute lymphoblastic leukemia

Zawitkowska¹,

Lejman

Drabko³

et al. 2020

Medicine

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Introduction: Children with acute lymphoblastic leukemia (ALL) are at a risk of developing influenza-related complications. Approximately 10% of influenza-infected children with ALL or other types of cancer need intensive care, and 5% of them eventually die. Patients’ concerns: We report 2 children with ALL and the swine-origin influenza A virus infection. Diagnosing influenza in them was a challenge. Medical records of these children were reviewed for demographic, clinical, and laboratory data. Patients were hospitalized in the Department of Pediatric Hematology, Oncology, and Transplantology of the Medical University of Lublin, Poland. Case 1 involved a 2-year-old girl who, according to acute lymphoblastic leukemia intercontinental Berlin-Frankfürt-Münster protocol 2009, started chemotherapy in July 2015. She was categorized in the intermediate risk group and received the induction and consolidation phase of the therapy without severe complications. The reinduction therapy was administered in the outpatient department till the 15 th day. On the 20 th day of this phase, she was admitted to our department with fever, mucositis, tachypnea, abdominal pain, and diarrhea. In September 2009, a 14-year-old boy (case 2) who, according to acute lymphoblastic leukemia intercontinental Berlin-Frankfürt-Münster protocol 2002, was categorized in the high-risk (HR) group, received the induction (Protocol I) phase of therapy without severe complications. On the 7 th day of the HR-1 course, he manifested fever and strong, tiring cough, followed by strong mucositis. Chemotherapy had to be interrupted in both children. Diagnosis: Respiratory viral infections, causing pneumonia, occurred in both patients during anticancer treatment. Initially, the real-time polymerase chain reaction test for the swine-origin influenza A was negative in both patients, which delayed the diagnosis. Additionally, bacterial, and fungal complications were also observed. Interventions: Both patients received oseltamivir twice a day, a broad-spectrum antibiotic, antifungal drug, and granulocyte colony growth factor. Outcomes: The disease progressed quickly, and our patients subsequently died. Conclusion: We speculated that early antiviral treatment can help in the better management of patients in the HR group. It is also important to minimize influenza morbidity and mortality by vaccinating family members, using empiric therapy, providing immediate antiviral therapy, and educating parents about hygiene measures.

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Cytokine Storm Syndrome Associated with Hemorrhagic Fever and Other Viruses

Sen

Ramanan

2019

Cytokine Storm Syndrome

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Analysis of Fatal Cases of Pandemic Influenza A (H1N1) Virus Infections in Pediatric Patients with Leukemia

Abstract: Pandemic H1N1 influenza virus caused mortality in patients with ARDS or HLH; an unexpected finding for pandemic H1N1 (2009) influenza virus. Thus, for children with leukemia and infected with H1N1 virus, short- and long-term complications should be kept in mind during evaluation.

Cited by 12 publications

References 24 publications

Acute respiratory infections in children and adolescents with acute lymphoblastic leukemia

Acute respiratory infections in children and adolescents with acute lymphoblastic leukemia

Diagnostic difficulties of AH1N1 influenza infection in children with acute lymphoblastic leukemia

Cytokine Storm Syndrome Associated with Hemorrhagic Fever and Other Viruses

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