Adenovirus infection among pediatric patients with cancer and in pediatric recipients of hematopoietic stem cell: A multicenter nationwide study |
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| Authors: | O. Zając-Spychała A. Pieczonka J. Wachowiak J. Frączkiewicz M. Salamonowicz K. Kałwak E. Gorczyńska B. Kazanowska G. Wróbel A. Chybicka K. Czyżewski M. Dziedzic M. Wysocki P. Zalas-Więcek A. Szmydki-Baran Ł. Hutnik M. Matysiak N. Irga-Jaworska E. Bień E. Drożyńska W. Stolpa G. Sobol-Milejska F. Pierlejewski W. Młynarski O. Gryniewicz–Kwiatkowska A. Gietka B. Dembowska-Bagińska K. Semczuk K. Dzierżanowska-Fangrat Z. Gamrot-Pyka M. Woszczyk A. Urbanek-Dądela G. Karolczyk M. Płonowski M. Krawczuk-Rybak A. Zaucha-Prażmo J. Kowalczyk J. Goździk J. Styczyński |
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| Affiliation: | 1. Department of Pediatric Oncology, Hematology and Transplantology, University of Medical Sciences, Poznan, Poland;2. Department of Pediatric Stem Cell Transplantation, Hematology and Oncology, Medical University, Wroclaw, Poland;3. Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz, Poland;4. Department of Microbiology, Collegium Medicum, Nicolaus Copernicus University, Torun, Poland;5. Department of Pediatric Hematology and Oncology, Medical University Torun, Bydgoszcz, Poland;6. Department of Pediatrics, Hematology and Oncology, Medical University, Gdansk, Poland;7. Department of Pediatric, Division of Pediatric Oncology, Hematology and Chemotherapy, Silesian Medical University, Katowice, Poland;8. Department of Pediatric Oncology, Hematology and Diabetology, Medical University, Lodz, Poland;9. Department of Oncology, Children's Memorial Health Institute, Warszawa, Poland;10. Department of Microbiology, Children's Memorial Health Institute, Warszawa, Poland;11. Division of Pediatric Hematology and Oncology, Chorzow Pediatric and Oncology Center, Chorzow, Poland;12. Division of Pediatric Hematology and Oncology, Children Hospital, Kielce, Poland;13. Department of Pediatric Oncology and Hematology, Medical University, Bialystok, Poland;14. Department of Pediatric Hematology, Oncology and Stem Cell Transplantation, Medical University, Lublin, Poland;15. Department of Clinical Immunology and Transplantology, Stem Cell Transplant Center, University Children's Hospital, Jagiellonian University Collegium Medicum, Krakow, Poland |
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| Abstract: | The aim was to evaluate the incidence, clinical course, and outcome of adenoviral infection (AdVI) in pediatric patients diagnosed and treated due to cancer and in pediatric recipients of hematopoietic stem cell. Over a 72-month period, all-in 5599 children with cancer: 2441 patients with hematological malignancy (HM) and 3158 with solid tumors (ST), and 971 patients after transplantation: 741 after allogeneic (allo-HSCT) and 230 after autologous (auto-HSCT) were enrolled into the study. Among cancer patients, 67 episodes of AdVI appeared in 63 (1.1%) children, including 45 (1.8%) with HM and 18 (0.6%; P < .001) with ST. Within transplanted patients, AdVIs were responsible for 88 episodes in 81 (8.3%) children (P < .001), including 78 (10.5%) patients after allo-HSCT and 3 (1.3%) after auto-HSCT. Time to develop AdVI was short, especially after allo-HSCT. The most common clinical manifestation in cancer patients was enteritis diagnosed in 63 (94.0%) cases, while among HSCT recipient asymptomatic adenoviremia was found in 36 (40.9%) cases and the most common clinical manifestation was urinary tract infection. Cancer patients with disseminated disease, as well as HSCT recipients with either asymptomatic viremia or disseminated disease, received antiviral treatment. The most commonly used first-line therapy was cidofovir. None of the cancer patients died due to AdVI, while within HSCT recipients three patients developed disseminated adenoviral disease and died despite antiviral treatment. In cancer patients, AdVIs are rare and associated with very good prognosis even without specific treatment. However, in allo-HSCT recipients, disseminated disease with fatal outcome is more likely to occur. |
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| Keywords: | adenovirus cancer children hematopoietic stem cell transplantation |
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