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Epidemiology and clinical characteristics of pandemic (H1N1) 2009 influenza infection in pediatric hemato‐oncology and hematopoietic stem cell transplantation patients
Author(s) -
Babor F.,
Grund S.,
Siepermann M.,
Oommen P.T.,
Kuhlen M.,
Schuster F.R.,
Laws H.J.,
Wessalowski R.,
Bienemann K.,
Janßen G.,
Adams O.,
Borkhardt A.,
Meisel R.
Publication year - 2012
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.12013
Subject(s) - medicine , zanamivir , oseltamivir , hematopoietic stem cell transplantation , transplantation , intensive care medicine , pediatrics , surgery , disease , covid-19 , infectious disease (medical specialty)
Background For children with hemato‐oncologic diseases, especially after hematopoietic stem cell transplantation ( HSCT ), the risk for developing complications related to pandemic influenza A (H1N1) 2009 (pH1N1) infection is largely unknown. Methods A retrospective chart study was performed of pH1N1 cases diagnosed between O ctober 2009 to J anuary 2010 in the hemato‐oncologic unit of the U niversity C hildren's H ospital of D üsseldorf, G ermany. Findings In total, 21 children were diagnosed with laboratory‐confirmed pH1N1; in 16 patients with malignancies (acute leukemia 7, lymphoma 4, solid tumors 2, others 3) and in 5 with benign hematologic disorders. Five patients had undergone prior HSCT , although 1 patient was diagnosed during conditioning therapy with high‐dose chemotherapy in preparation for haploidentical HSCT . Most frequent symptoms were fever (>38.5°C) and cough (in 100%), and rhinorrhea (57%). The 2 patients acquiring pH1N1 infection under high‐dose or intensive chemotherapy did not require intensive care or mechanical ventilation, and both recovered under antiviral therapy. Oseltamivir was administered to 11 patients; in 1 patient, therapy was switched, on a compassionate‐use basis, to intravenous zanamivir because of lack of clinical improvement after oseltamivir therapy. Complications were hospitalization (19%), demand of oxygen supplementation, delay/interruption of antineoplastic therapy, and prolonged administration of antibiotics and antipyretics. Conclusion In the investigated patient population, pH1N1 was mild in most cases, but was associated with substantial morbidity in a proportion of patients and led to interruption and delay in anticancer treatment.