SARS-CoV-2 in pediatric cancer: a systematic review

AbstractThe outbreak of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in December 2019 in Wuhan challenges pediatric oncologists in an unexpected way. We provide a comprehensive overview, which systematically summarizes and grades evidence (QoE) on SARS-CoV-2 infections in pediatric cancer patients at 1.5 years of pandemic. A systematic literature search in PubMed combined with an additional exploratory literature review in other international databases was conducted to identify studies on children (aged < 18 years) with a malignant disease and COVID-19 infections. In total, 45 reports on 1003 pediatric cancer patients with SARS-CoV-2 infections were identified out of 1397 reports analyzed. The clinical course of COVID-19 was reported mild or moderate in 358 patients (41.7%), whereas 11.1% of patients showed severe COVID-19. In 12.7% of patients, chemotherapy was postponed, whereas 19% of patients with different underlying malignancies received chemotherapy during SARS-CoV-2 infection. Twenty-five patients with SARS-CoV-2 infections died, potentially related to COVID-19.Conclusion: Despite a favorable COVID-19 outcome in most pediatric cancer patients, the morbidity is reported higher than in children without comorbidities. However, no severe COVID-19 complications were associated to the continuation of chemotherapy in some cohort studies and reports on two patients. Therefore, the risk of cancer progress or relapse due to interruption of chemotherapy has carefully to be weighed against the risk of severe COVID-19 disease with potentially fatal outcome. What is Known:• Most of pediatric patients with malignant diseases show an asymptomatic, mild or moderate clinical course of SARS-CoV-2 infection. • Current need for a basis for decision-making, whether to stop or interrupt cancer treatment in a patient infected with SARS-CoV-2, and when to continue chemotherapy. What is New:• Review results comprising over 1000 pediatric COVID-19 cancer patients confirm mild courses of SARS-CoV-2 infection in most patients but also show the attributable mortality is at least 10 times higher compared to reports on hospitalized children without comorbidities.• Review identifies that chemotherapy was continued despite SARS-CoV-2 positivity in 18% of patients with individual chemotherapy modification according to the clinical course of SARS-CoV-2 infection and existing comorbidities. On this basis, no severe COVID-19 complications were associated to the continuation of chemotherapy in several cohort studies and two case reports.

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Collaborative Legacy Building to Alleviate Emotional Pain and Suffering in Pediatric Cancer Patients: A Case Review

Children ◽

10.3390/children9010033 ◽

2022 ◽

Vol 9 (1) ◽

pp. 33

Author(s):

Laura Cahalan ◽

Ashley Smith ◽

Melissa Sandoval ◽

Gwendolyn Parks ◽

Zachary Gresham

Keyword(s):

Cancer Patients ◽

Pediatric Cancer ◽

Case Review ◽

Comprehensive Overview ◽

Building Projects ◽

Team Members ◽

Emotional Healing ◽

Pediatric Cancer Patients ◽

Life Threatening ◽

Building Activities

Childhood cancer patients experience emotional hardship associated with their life-threatening diagnoses. Interdisciplinary team members working in pediatric cancer care can help alleviate physical pain and psychological suffering of children by facilitating collaborative legacy-building activities with patients and families. The contents of this article aim to support legacy building as a medium for emotional healing prior to the end of life. The authors use a case review to contextualize legacy-building projects and provide a comprehensive overview of methods and considerations for these initiatives.

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2689. Stenotrphomonas maltophilia, The Hidden Threat Among Pediatric Cancer Patients

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.2366 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S944-S945

Author(s):

Youssef Madney. Said ◽

Riham Abdelaziz ◽

Shimaa Samir ◽

Mervat Elanany

Keyword(s):

Mortality Rate ◽

Cancer Patients ◽

Solid Tumors ◽

Pediatric Cancer ◽

Hematological Malignancies ◽

Lymphoblastic Leukemia ◽

Significant Risk ◽

Attributable Mortality ◽

Cell Transplant ◽

Pediatric Cancer Patients

Abstract Background Stenotrophomonas maltophilia is an emerging nosocomial pathogen in immunocompromised patients. Although S. maltophilia exhibits limited pathogenicity in immunocompetent hosts, it has been shown to cause fatal infections in patients with malignancies. The objective of this study to analyze the clinical characteristics, susceptibility pattern, and treatment outcome of S. maltophilia among pediatric cancer patients. Methods Retrospective analysis including all pediatric cancer patients treated at children cancer hospital Egypt (CCHE) with S. maltophilia bloodstream infection from June 2013 till June 2018. Results 281 isolates among 135 pediatric cancer patients. Most are hematological malignancies 67(50%), solid tumors 55 (40%) and post-transplant 13(10%). Most common hematological malignancies were acute lymphoblastic leukemia 34 patients (25%) while brain tumor was the most common solid tumors 20 patients (15%). The spectrum of infections includes bacteremia in 61 patients (45%) catheter-related in 34 (25%), pneumonia in 22 (16%), skin and soft-tissue infection in 11(8%) meningitis in 5 (3%) and disseminated infections with multiorgan involvement in 4(3%) patients. 46 patients (34%) was admitted in intensive care unit (ICU), 67 inpatient (50%), 11 (8%) stem cell transplant unit and 11 patient (8%) from emergency and outpatient department. The isolates revealed 80% susceptibility to Trimethoprim-Sulfamethoxazole (TMP-SMX), 77% to ciprofloxacin, 50% to cefepime and ceftazidime, 63% to amikacin, 48% to piperacillin–tazobactam, 93% to colistin, 97% to tigecycline. Day 30 mortality (Crude mortality rate) 33 patients (25%) while S. maltophilia attributable mortality (died within 7 days of culture isolation) was 17 patients (13%). Patients with pneumonia, (TMP-SMX) resistance and ICU admission were associated with a significant risk of mortality. Conclusion Stenotrphomonas bloodstream is a serious pathogen and hidden threat among pediatric cancer patients associated with high mortality rate. Disclosures All authors: No reported disclosures.

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