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  • Rare but Manageable:...

Rare but Manageable: Pediatric Patients with Leukemia Navigate COVID-19 Challenges

Written By : Dr.Niharika Harsha B |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2024-03-06T18:45:28+05:30  |  Updated On 7 March 2024 12:00 PM IST
Rare but Manageable: Pediatric Patients with Leukemia Navigate COVID-19 Challenges
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In a groundbreaking retrospective case series, researchers from St Jude Children's Research Hospital and its affiliate sites shed light on the impact of COVID-19 on pediatric patients undergoing treatment for acute lymphoblastic leukemia or lymphoma (ALL/LLy). These findings contribute to our understanding of the interplay between COVID-19 and cancer treatment in pediatric patients, highlighting the challenges in maintaining chemotherapy schedules and the importance of considering individual patient characteristics in managing COVID-19 in this population.

The study results were published in the journal JAMA Network Open.

A detailed description of COVID-19 in pediatric patients with acute lymphoblastic leukemia or lymphoma (ALL/LLy) has not been provided, and its potential impact on both chemotherapy administration and long-term outcomes remains unclear. Hence, researchers conducted a study to describe the clinical presentation of COVID-19 and chemotherapy modifications in pediatric patients with ALL/LLy.

Also Read: Breastfeeding may reduce risk of leukemia in children

The study, conducted between March 30, 2020, and June 20, 2022, on patients treated with the Total XVII protocol, offers valuable insights into the clinical presentation of COVID-19 and the subsequent modifications in chemotherapy administration. Of the 308 pediatric patients included in the study, 110 (36%) were diagnosed with COVID-19 at a median age of 8.2 years.

Findings:

  • The majority of cases occurred during the continuation/maintenance phase of chemotherapy, emphasizing the vulnerability of patients during this crucial period of their treatment journey.
  • Remarkably, severe cases of COVID-19 were rare, accounting for only 6% of the affected patients.
  • However, these severe instances were associated with specific factors, including older age, higher white blood cell counts at the time of ALL/LLy diagnosis, lower absolute lymphocyte counts at the onset of COVID-19, abnormal chest imaging findings, and instances of SARS-CoV-2 reinfection.
  • Unprecedented in its scope, the study also highlighted rare but serious thrombotic events, such as pulmonary embolism and cerebral venous sinus thrombosis, occurring in isolated cases.
  • Notably, no cases of multisystem inflammatory syndrome in children or deaths were reported among the pediatric patients.
  • One of the significant challenges revealed by the study was the impact on chemotherapy administration.
  • Chemotherapy interruptions affected a substantial 87% of the patients, leading to a careful examination of the duration of these interruptions.
Also Read: Obesity and high weight linked to adverse outcomes in leukemia treatment

Patients with severe disease, SARS-CoV-2 reinfection, and those diagnosed during the pre-Omicron variant period experienced longer interruptions compared to their counterparts diagnosed after December 27, 2021, when the Omicron variant emerged. SARS-CoV-2 reinfection emerged as a noteworthy aspect, occurring in 10% of patients and being more prevalent in older age groups and those receiving standard or high-risk ALL/LLy therapy. This finding underscores the need for tailored approaches to managing COVID-19 in pediatric patients, considering their specific treatment protocols. The study's authors emphasized the necessity of conducting long-term studies to fully comprehend the outcomes of COVID-19 in this unique pediatric population. As the medical community continues to navigate the challenges posed by the pandemic, these findings contribute significantly to the evolving understanding of the intersection between COVID-19 and pediatric oncology, offering hope and insights for the future.

Further reading: Hashmi SK, Bodea J, Patni T, et al. COVID-19 in Pediatric Patients With Acute Lymphoblastic Leukemia or Lymphoma. JAMA Netw Open. 2024;7(2):e2355727. doi:10.1001/jamanetworkopen.2023.55727

JAMA Network OpenJAMAAcute Lymphoblastic LeukemiaSaman K. HashmiPediatrics
Source : JAMA Network Open
Dr.Niharika Harsha B
Dr.Niharika Harsha B

    BDS, MDS

    Dr.Niharika Harsha B (BDS,MDS) completed her BDS from Govt Dental College, Hyderabad and MDS from Dr.NTR University of health sciences(Now Kaloji Rao University). She has 4 years of private dental practice and worked for 2 years as Consultant Oral Radiologist at a Dental Imaging Centre in Hyderabad. She worked as Research Assistant and scientific writer in the development of Oral Anti cancer screening device with her seniors. She has a deep intriguing wish in writing highly engaging, captivating and informative medical content for a wider audience. She can be contacted at editorial@medicaldialogues.in.

    Dr. Kamal Kant Kohli
    Dr. Kamal Kant Kohli

    Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

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