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Long-term morbidity of respiratory viral infections during chemotherapy in children with leukaemia.

ABSTRACT: BACKGROUND:Respiratory viruses are a common cause of infection in immunosuppressed children undergoing cancer therapy. Pulmonary sequelae have been documented following respiratory viral infections (RVIs) in hematopoietic stem cell transplant (HSCT) recipients; however potential late effects in children undergoing nonmyeloablative chemotherapy have not been investigated. AIM:To evaluate the long-term pulmonary morbidity of respiratory viral infections during chemotherapy in children with acute lymphoblastic leukemia (ALL). METHODS:Childhood ALL survivors, aged 7 to 18 years, greater than 6 months posttreatment were recruited. Exclusion criteria included HSCT or proven bacterial/fungal respiratory infection during treatment. Subjects were classified into "viral" or "control" groups according to retrospective medical records that documented the presence of laboratory-proven RVIs during chemotherapy. Symptom questionnaires (Liverpool, ISAAC) and lung function testing (spirometry, plethysmography, diffusing capacity, forced oscillation technique to ATS/ERS standards) were then performed cross-sectionally at the time of recruitment. RESULTS:Fifty-four patients (31 viral, 23 control) were recruited: median (range) age 11.2 (7.2-18.1) years, and at 4.9 (0.5-13) years posttherapy. Abnormalities were detected in 17 (31%) individuals (8 viral, 9 control), with the most common being DLCO impairment (3 viral, 4 control) and reduced respiratory reactance at 5?Hz (5 viral, 6 control). Children with RVIs during chemotherapy reported more current respiratory symptoms, particularly wheeze (odds ratio [OR], 3.0; 95% confidence interval [CI]: 0.9-10.0; P?=?.09) and cough (OR, 2.7; 95% CI: 0.8-9.5; P?=?.11). No differences in lung function tests were observed between the two groups. CONCLUSIONS:Our study found children with RVIs during chemotherapy developed more long-term respiratory symptoms than controls; however, differences did not reach statistical significance. No differences in static lung function were found between the two groups. Overall, pulmonary abnormalities and/or significant ongoing respiratory symptoms were detected in nearly a third of ALL survivors treated without HSCT. Larger, prospective studies are warranted to evaluate the etiology and clinical significance of these findings.

SUBMITTER: Lin B

PROVIDER: S-EPMC7167615 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Long-term morbidity of respiratory viral infections during chemotherapy in children with leukaemia.

Lin Beryl B Kennedy Brendan B McBride Jamie J Dalla-Pozza Luciano L Trahair Toby T McCowage Geoffrey G Coward Emma E Plush Leanne L Robinson Paul D PD Hardaker Kate K Widger John J Ng Anthea A Jaffe Adam A Selvadurai Hiran H

Pediatric pulmonology 20190808 11

<h4>Background</h4>Respiratory viruses are a common cause of infection in immunosuppressed children undergoing cancer therapy. Pulmonary sequelae have been documented following respiratory viral infections (RVIs) in hematopoietic stem cell transplant (HSCT) recipients; however potential late effects in children undergoing nonmyeloablative chemotherapy have not been investigated.<h4>Aim</h4>To evaluate the long-term pulmonary morbidity of respiratory viral infections during chemotherapy in childr ...[more]

PMID: 31393087

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Long-term morbidity of respiratory viral infections during chemotherapy in children with leukaemia.

Publications

Long-term morbidity of respiratory viral infections during chemotherapy in children with leukaemia.

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