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Zając-Spychała O, Pieczonka A, Wachowiak J, Frączkiewicz J, Salamonowicz M, Kałwak K, Gorczyńska E, Kazanowska B, Wróbel G, Chybicka A, Czyżewski K, Dziedzic M, Wysocki M, Zalas-Więcek P, Szmydki-Baran A, Hutnik Ł, Matysiak M, Irga-Jaworska N, Bień E, Drożyńska E, Stolpa W, Sobol-Milejska G, Pierlejewski F, Młynarski W, Gryniewicz-Kwiatkowska O, Gietka A, Dembowska-Bagińska B, Semczuk K, Dzierżanowska-Fangrat K, Gamrot-Pyka Z, Woszczyk M, Urbanek-Dądela A, Karolczyk G, Płonowski M, Krawczuk-Rybak M, Zaucha-Prażmo A, Kowalczyk J, Goździk J, Styczyński J. Adenovirus infection among pediatric patients with cancer and in pediatric recipients of hematopoietic stem cell: A multicenter nationwide study. J Med Virol 2020; 92:3187-3193. [PMID: 32162698 DOI: 10.1002/jmv.25756] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 02/26/2020] [Accepted: 03/04/2020] [Indexed: 01/07/2023]
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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Affiliation(s)
- O Zając-Spychała
- Department of Pediatric Oncology, Hematology and Transplantology, University of Medical Sciences, Poznan, Poland
| | - A Pieczonka
- Department of Pediatric Oncology, Hematology and Transplantology, University of Medical Sciences, Poznan, Poland
| | - J Wachowiak
- Department of Pediatric Oncology, Hematology and Transplantology, University of Medical Sciences, Poznan, Poland
| | - J Frączkiewicz
- Department of Pediatric Stem Cell Transplantation, Hematology and Oncology, Medical University, Wroclaw, Poland
| | - M Salamonowicz
- Department of Pediatric Stem Cell Transplantation, Hematology and Oncology, Medical University, Wroclaw, Poland
| | - K Kałwak
- Department of Pediatric Stem Cell Transplantation, Hematology and Oncology, Medical University, Wroclaw, Poland
| | - E Gorczyńska
- Department of Pediatric Stem Cell Transplantation, Hematology and Oncology, Medical University, Wroclaw, Poland
| | - B Kazanowska
- Department of Pediatric Stem Cell Transplantation, Hematology and Oncology, Medical University, Wroclaw, Poland
| | - G Wróbel
- Department of Pediatric Stem Cell Transplantation, Hematology and Oncology, Medical University, Wroclaw, Poland
| | - A Chybicka
- Department of Pediatric Stem Cell Transplantation, Hematology and Oncology, Medical University, Wroclaw, Poland
| | - K Czyżewski
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz, Poland
| | - M Dziedzic
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz, Poland
| | - M Wysocki
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz, Poland
| | - P Zalas-Więcek
- Department of Microbiology, Collegium Medicum, Nicolaus Copernicus University, Torun, Poland
| | - A Szmydki-Baran
- Department of Pediatric Hematology and Oncology, Medical University Torun, Bydgoszcz, Poland
| | - Ł Hutnik
- Department of Pediatric Hematology and Oncology, Medical University Torun, Bydgoszcz, Poland
| | - M Matysiak
- Department of Pediatric Hematology and Oncology, Medical University Torun, Bydgoszcz, Poland
| | - N Irga-Jaworska
- Department of Pediatrics, Hematology and Oncology, Medical University, Gdansk, Poland
| | - E Bień
- Department of Pediatrics, Hematology and Oncology, Medical University, Gdansk, Poland
| | - E Drożyńska
- Department of Pediatrics, Hematology and Oncology, Medical University, Gdansk, Poland
| | - W Stolpa
- Department of Pediatric, Division of Pediatric Oncology, Hematology and Chemotherapy, Silesian Medical University, Katowice, Poland
| | - G Sobol-Milejska
- Department of Pediatric, Division of Pediatric Oncology, Hematology and Chemotherapy, Silesian Medical University, Katowice, Poland
| | - F Pierlejewski
- Department of Pediatric Oncology, Hematology and Diabetology, Medical University, Lodz, Poland
| | - W Młynarski
- Department of Pediatric Oncology, Hematology and Diabetology, Medical University, Lodz, Poland
| | | | - A Gietka
- Department of Oncology, Children's Memorial Health Institute, Warszawa, Poland
| | | | - K Semczuk
- Department of Microbiology, Children's Memorial Health Institute, Warszawa, Poland
| | | | - Z Gamrot-Pyka
- Division of Pediatric Hematology and Oncology, Chorzow Pediatric and Oncology Center, Chorzow, Poland
| | - M Woszczyk
- Division of Pediatric Hematology and Oncology, Chorzow Pediatric and Oncology Center, Chorzow, Poland
| | - A Urbanek-Dądela
- Division of Pediatric Hematology and Oncology, Children Hospital, Kielce, Poland
| | - G Karolczyk
- Division of Pediatric Hematology and Oncology, Children Hospital, Kielce, Poland
| | - M Płonowski
- Department of Pediatric Oncology and Hematology, Medical University, Bialystok, Poland
| | - M Krawczuk-Rybak
- Department of Pediatric Oncology and Hematology, Medical University, Bialystok, Poland
| | - A Zaucha-Prażmo
- Department of Pediatric Hematology, Oncology and Stem Cell Transplantation, Medical University, Lublin, Poland
| | - J Kowalczyk
- Department of Pediatric Hematology, Oncology and Stem Cell Transplantation, Medical University, Lublin, Poland
| | - J Goździk
- Department of Clinical Immunology and Transplantology, Stem Cell Transplant Center, University Children's Hospital, Jagiellonian University Collegium Medicum, Krakow, Poland
| | - J Styczyński
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz, Poland
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Zając-Spychała O, Skalska-Sadowska J, Wachowiak J, Szmydki-Baran A, Hutnik Ł, Matysiak M, Pierlejewski F, Młynarski W, Czyżewski K, Dziedzic M, Wysocki M, Zalas-Więcek P, Bartnik M, Ociepa T, Urasiński T, Małas Z, Badowska W, Gamrot-Pyka Z, Woszczyk M, Tomaszewska R, Szczepański T, Irga-Jaworska N, Drożyńska E, Urbanek-Dądela A, Karolczyk G, Płonowski M, Krawczuk-Rybak M, Frączkiewicz J, Salamonowicz M, Chybicka A, Stolpa W, Sobol-Milejska G, Chełmecka-Wiktorczyk L, Balwierz W, Zak I, Gryniewicz-Kwiatkowska O, Gietka A, Dembowska-Bagińska B, Semczuk K, Dzierżanowska-Fangrat K, Musiał J, Chaber R, Kowalczyk J, Styczyński J. Infections in children with acute myeloid leukemia: increased mortality in relapsed/refractory patients. Leuk Lymphoma 2019; 60:3028-3035. [PMID: 31132917 DOI: 10.1080/10428194.2019.1616185] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The aim of this nationwide study was to describe the epidemiology and profile of bacterial infections (BI), invasive fungal disease (IFD) and viral infections (VI) in patients with de novo and relapsed/refractory (rel/ref) acute myeloid leukemia (AML). Within the studied group of 250 children with primary AML, at least one infectious complication (IC) was diagnosed in 76.0% (n = 190) children including 85.1% (n = 504) episodes of BI, 8.3% (n = 49) - IFD and 6.6% (n = 39) - VI. Among 61 patients with rel/ref AML, at least one IC was found in 67.2% (n = 41) of children including 78.8% (n = 78) of BI, 14.1% (n = 14) of IFD and 7.1% (n = 7) of VI. In all AML patients, within BI Gram-negative strains were predominant. Half of these strains were multi-drug resistant. Characteristics of IFD and VI were comparable for de novo and rel/ref AML. The infection-related mortality was significantly higher, while survival from infection was significantly lower in patients with rel/ref disease.
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Affiliation(s)
- Olga Zając-Spychała
- Department of Pediatric Oncology, Hematology and Transplantology, University of Medical Sciences, Poznan, Poland
| | - Jolanta Skalska-Sadowska
- Department of Pediatric Oncology, Hematology and Transplantology, University of Medical Sciences, Poznan, Poland
| | - Jacek Wachowiak
- Department of Pediatric Oncology, Hematology and Transplantology, University of Medical Sciences, Poznan, Poland
| | - Anna Szmydki-Baran
- Department of Pediatric Hematology and Oncology, Medical University, Warszawa, Poland
| | - Łukasz Hutnik
- Department of Pediatric Hematology and Oncology, Medical University, Warszawa, Poland
| | - Michał Matysiak
- Department of Pediatric Hematology and Oncology, Medical University, Warszawa, Poland
| | - Filip Pierlejewski
- Department of Pediatric Oncology, Hematology and Diabetology, Medical University, Lodz, Poland
| | - Wojciech Młynarski
- Department of Pediatric Oncology, Hematology and Diabetology, Medical University, Lodz, Poland
| | - Krzysztof Czyżewski
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz, Poland
| | - Magdalena Dziedzic
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz, Poland
| | - Mariusz Wysocki
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz, Poland
| | - Patrycja Zalas-Więcek
- Department of Microbiology, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz, Poland
| | - Magdalena Bartnik
- Department of Pediatrics and Oncology, Pomeranian Medical University, Szczecin, Poland
| | - Tomasz Ociepa
- Department of Pediatrics and Oncology, Pomeranian Medical University, Szczecin, Poland
| | - Tomasz Urasiński
- Department of Pediatrics and Oncology, Pomeranian Medical University, Szczecin, Poland
| | - Zofia Małas
- Division of Pediatric Hematology and Oncology, Children Hospital, Olsztyn, Poland
| | - Wanda Badowska
- Division of Pediatric Hematology and Oncology, Children Hospital, Olsztyn, Poland
| | - Zuzanna Gamrot-Pyka
- Division of Pediatric Hematology and Oncology, Chorzow Pediatric and Oncology Center, Chorzow, Poland
| | - Mariola Woszczyk
- Division of Pediatric Hematology and Oncology, Chorzow Pediatric and Oncology Center, Chorzow, Poland
| | - Renata Tomaszewska
- Department of Pediatric Hematology and Oncology, Silesian Medical University, Zabrze, Poland
| | - Tomasz Szczepański
- Department of Pediatric Hematology and Oncology, Silesian Medical University, Zabrze, Poland
| | - Nina Irga-Jaworska
- Department of Pediatrics, Hematology and Oncology, Medical University, Gdansk, Poland
| | - Elżbieta Drożyńska
- Department of Pediatrics, Hematology and Oncology, Medical University, Gdansk, Poland
| | | | - Grażyna Karolczyk
- Division of Pediatric Hematology and Oncology, Children Hospital, Kielce, Poland
| | - Marcin Płonowski
- Department of Pediatric Oncology and Hematology, Medical University, Bialystok, Poland
| | - Maryna Krawczuk-Rybak
- Department of Pediatric Oncology and Hematology, Medical University, Bialystok, Poland
| | - Jowita Frączkiewicz
- Department of Pediatric Stem Cell Transplantation, Hematology and Oncology, Medical University, Wroclaw, Poland
| | - Malgorzata Salamonowicz
- Department of Pediatric Stem Cell Transplantation, Hematology and Oncology, Medical University, Wroclaw, Poland
| | - Alicja Chybicka
- Department of Pediatric Stem Cell Transplantation, Hematology and Oncology, Medical University, Wroclaw, Poland
| | - Weronika Stolpa
- Division of Pediatric Oncology, Hematology and Chemotherapy, Department of Pediatrics, Silesian Medical University, Katowice, Poland
| | - Grazyna Sobol-Milejska
- Division of Pediatric Oncology, Hematology and Chemotherapy, Department of Pediatrics, Silesian Medical University, Katowice, Poland
| | - Liliana Chełmecka-Wiktorczyk
- Department of Pediatric Oncology and Hematology, University Children's Hospital, Jagiellonian University, Collegium Medicum, Krakow, Poland
| | - Walentyna Balwierz
- Department of Pediatric Oncology and Hematology, University Children's Hospital, Jagiellonian University, Collegium Medicum, Krakow, Poland
| | - Iwona Zak
- Department of Microbiology, University Children's Hospital, Jagiellonian University, Collegium Medicum, Krakow, Poland
| | | | - Aneta Gietka
- Department of Oncology, Children's Memorial Health Institute, Warszawa, Poland
| | | | - Katarzyna Semczuk
- Department of Microbiology, Children's Memorial Health Institute, Warszawa, Poland
| | | | - Jakub Musiał
- Department of Pediatric Oncohematology, Children Hospital, Rzeszow, Poland
| | - Radoslaw Chaber
- Department of Pediatric Oncohematology, Children Hospital, Rzeszow, Poland
| | - Jerzy Kowalczyk
- Department of Pediatric Hematology, Oncology and Stem Cell Transplantation, Medical University, Lublin, Poland
| | - Jan Styczyński
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz, Poland
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