Pandemic (H1N1) 2009 influenza in Canadian pediatric cancer and hematopoietic stem cell transplant patients.
Identifieur interne : 000422 ( Main/Exploration ); précédent : 000421; suivant : 000423Pandemic (H1N1) 2009 influenza in Canadian pediatric cancer and hematopoietic stem cell transplant patients.
Auteurs : Dat Tran [Canada] ; Michelle Science ; David Dix ; Carol Portwine ; Shayna Zelcer ; Donna L. Johnston ; Rochelle Yanofsky ; Adam Gassas ; Marie-Chantal Ethier ; Lillian SungSource :
- Influenza and other respiratory viruses [ 1750-2659 ] ; 2012.
Descripteurs français
- KwdFr :
- Adolescent, Antiviraux (administration et posologie), Canada (épidémiologie), Enfant, Enfant d'âge préscolaire, Excrétion virale, Facteurs temps, Femelle, Grippe humaine (anatomopathologie), Grippe humaine (traitement médicamenteux), Grippe humaine (virologie), Grippe humaine (épidémiologie), Humains, Hôpitaux pédiatriques, Mâle, Nourrisson, Oséltamivir (administration et posologie), Résultat thérapeutique, Sous-type H1N1 du virus de la grippe A (isolement et purification), Transplantation de cellules souches hématopoïétiques, Tumeurs (), Études rétrospectives.
- MESH :
- administration et posologie : Antiviraux, Oséltamivir.
- anatomopathologie : Grippe humaine.
- isolement et purification : Sous-type H1N1 du virus de la grippe A.
- traitement médicamenteux : Grippe humaine.
- virologie : Grippe humaine.
- épidémiologie : Canada, Grippe humaine.
- Adolescent, Enfant, Enfant d'âge préscolaire, Excrétion virale, Facteurs temps, Femelle, Humains, Hôpitaux pédiatriques, Mâle, Nourrisson, Résultat thérapeutique, Transplantation de cellules souches hématopoïétiques, Tumeurs, Études rétrospectives.
- Wicri :
- geographic : Canada.
English descriptors
- KwdEn :
- Adolescent, Antiviral Agents (administration & dosage), Canada (epidemiology), Child, Child, Preschool, Female, Hematopoietic Stem Cell Transplantation, Hospitals, Pediatric, Humans, Infant, Influenza A Virus, H1N1 Subtype (isolation & purification), Influenza, Human (drug therapy), Influenza, Human (epidemiology), Influenza, Human (pathology), Influenza, Human (virology), Male, Neoplasms (complications), Neoplasms (therapy), Oseltamivir (administration & dosage), Retrospective Studies, Time Factors, Treatment Outcome, Virus Shedding.
- MESH :
- chemical , administration & dosage : Antiviral Agents, Oseltamivir.
- geographic , epidemiology : Canada.
- complications : Neoplasms.
- drug therapy : Influenza, Human.
- epidemiology : Influenza, Human.
- isolation & purification : Influenza A Virus, H1N1 Subtype.
- pathology : Influenza, Human.
- therapy : Neoplasms.
- virology : Influenza, Human.
- Adolescent, Child, Child, Preschool, Female, Hematopoietic Stem Cell Transplantation, Hospitals, Pediatric, Humans, Infant, Male, Retrospective Studies, Time Factors, Treatment Outcome, Virus Shedding.
Abstract
BACKGROUND
The impact of pandemic H1N1 influenza (pH1N1) virus in pediatric cancer is uncertain. The objectives of this study were to characterize the clinical course of pH1N1 and identify factors associated with severe outcomes.
METHODS
We conducted a Canadian multicenter retrospective review of children with cancer and stem cell transplant (SCT) recipients who were diagnosed with laboratory-confirmed pH1N1 infection between May 1, 2009 and January 31, 2010.
RESULTS
We identified 100 (19 in wave 1 and 81 in wave 2) cases of pH1N1 infection. Median age was 8.7 years. 71% had a hematologic malignancy, and 20% received SCT. Median duration of fever and illness was 2 and 12.5 days, respectively. 51 (51.5%) were hospitalized for a median of 5 days, with no deaths and only 1 requiring admission to the intensive care unit. Radiologically confirmed pneumonia was diagnosed in 10 (10%). Interruption of chemotherapy or conditioning occurred in 43 patients. In multivariable analyses, age <5 years (relative to ≥ 10 years) and neutropenia were associated with hospitalization while neutropenia was associated with pneumonia. Despite oseltamivir use in 89%, viral shedding was prolonged (median, 46 days) and often persisted after symptom resolution. However, an extended treatment course (>5 days) correlated with shortened duration of viral shedding (P=0.041).
CONCLUSIONS
pH1N1 infection in pediatric cancer and SCT patients infrequently caused complications but commonly interrupted cancer treatment. Persistent shedding of virus after illness resolution was common. Further research is needed to verify this finding as it could have implications for treatment guidelines and infection control practices.
DOI: 10.1111/j.1750-2659.2012.00352.x
PubMed: 22417068
Affiliations:
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Johnston</name></author><author><name sortKey="Yanofsky, Rochelle" sort="Yanofsky, Rochelle" uniqKey="Yanofsky R" first="Rochelle" last="Yanofsky">Rochelle Yanofsky</name></author><author><name sortKey="Gassas, Adam" sort="Gassas, Adam" uniqKey="Gassas A" first="Adam" last="Gassas">Adam Gassas</name></author><author><name sortKey="Ethier, Marie Chantal" sort="Ethier, Marie Chantal" uniqKey="Ethier M" first="Marie-Chantal" last="Ethier">Marie-Chantal Ethier</name></author><author><name sortKey="Sung, Lillian" sort="Sung, Lillian" uniqKey="Sung L" first="Lillian" last="Sung">Lillian Sung</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2012">2012</date><idno type="RBID">pubmed:22417068</idno><idno type="pmid">22417068</idno><idno type="doi">10.1111/j.1750-2659.2012.00352.x</idno><idno type="wicri:Area/Main/Corpus">000451</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000451</idno><idno type="wicri:Area/Main/Curation">000451</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000451</idno><idno type="wicri:Area/Main/Exploration">000451</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Pandemic (H1N1) 2009 influenza in Canadian pediatric cancer and hematopoietic stem cell transplant patients.</title><author><name sortKey="Tran, Dat" sort="Tran, Dat" uniqKey="Tran D" first="Dat" last="Tran">Dat Tran</name><affiliation wicri:level="1"><nlm:affiliation>Division of Infectious Diseases, The Hospital for Sick Children, Toronto, ON, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Division of Infectious Diseases, The Hospital for Sick Children, Toronto, ON</wicri:regionArea><wicri:noRegion>ON</wicri:noRegion></affiliation></author><author><name sortKey="Science, Michelle" sort="Science, Michelle" uniqKey="Science M" first="Michelle" last="Science">Michelle Science</name></author><author><name sortKey="Dix, David" sort="Dix, David" uniqKey="Dix D" first="David" last="Dix">David Dix</name></author><author><name sortKey="Portwine, Carol" sort="Portwine, Carol" uniqKey="Portwine C" first="Carol" last="Portwine">Carol Portwine</name></author><author><name sortKey="Zelcer, Shayna" sort="Zelcer, Shayna" uniqKey="Zelcer S" first="Shayna" last="Zelcer">Shayna Zelcer</name></author><author><name sortKey="Johnston, Donna L" sort="Johnston, Donna L" uniqKey="Johnston D" first="Donna L" last="Johnston">Donna L. 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xml:lang="fr"><term>Grippe humaine</term></keywords><keywords scheme="MESH" qualifier="virologie" xml:lang="fr"><term>Grippe humaine</term></keywords><keywords scheme="MESH" qualifier="virology" xml:lang="en"><term>Influenza, Human</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Canada</term><term>Grippe humaine</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Child</term><term>Child, Preschool</term><term>Female</term><term>Hematopoietic Stem Cell Transplantation</term><term>Hospitals, Pediatric</term><term>Humans</term><term>Infant</term><term>Male</term><term>Retrospective Studies</term><term>Time Factors</term><term>Treatment Outcome</term><term>Virus Shedding</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term><term>Enfant</term><term>Enfant d'âge préscolaire</term><term>Excrétion virale</term><term>Facteurs temps</term><term>Femelle</term><term>Humains</term><term>Hôpitaux pédiatriques</term><term>Mâle</term><term>Nourrisson</term><term>Résultat thérapeutique</term><term>Transplantation de cellules souches hématopoïétiques</term><term>Tumeurs</term><term>Études rétrospectives</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Canada</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>The impact of pandemic H1N1 influenza (pH1N1) virus in pediatric cancer is uncertain. The objectives of this study were to characterize the clinical course of pH1N1 and identify factors associated with severe outcomes.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>We conducted a Canadian multicenter retrospective review of children with cancer and stem cell transplant (SCT) recipients who were diagnosed with laboratory-confirmed pH1N1 infection between May 1, 2009 and January 31, 2010.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>We identified 100 (19 in wave 1 and 81 in wave 2) cases of pH1N1 infection. Median age was 8.7 years. 71% had a hematologic malignancy, and 20% received SCT. Median duration of fever and illness was 2 and 12.5 days, respectively. 51 (51.5%) were hospitalized for a median of 5 days, with no deaths and only 1 requiring admission to the intensive care unit. Radiologically confirmed pneumonia was diagnosed in 10 (10%). Interruption of chemotherapy or conditioning occurred in 43 patients. In multivariable analyses, age <5 years (relative to ≥ 10 years) and neutropenia were associated with hospitalization while neutropenia was associated with pneumonia. Despite oseltamivir use in 89%, viral shedding was prolonged (median, 46 days) and often persisted after symptom resolution. However, an extended treatment course (>5 days) correlated with shortened duration of viral shedding (P=0.041).</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>pH1N1 infection in pediatric cancer and SCT patients infrequently caused complications but commonly interrupted cancer treatment. Persistent shedding of virus after illness resolution was common. Further research is needed to verify this finding as it could have implications for treatment guidelines and infection control practices.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">22417068</PMID><DateCompleted><Year>2013</Year><Month>03</Month><Day>06</Day></DateCompleted><DateRevised><Year>2018</Year><Month>11</Month><Day>13</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1750-2659</ISSN><JournalIssue CitedMedium="Internet"><Volume>6</Volume><Issue>6</Issue><PubDate><Year>2012</Year><Month>Nov</Month></PubDate></JournalIssue><Title>Influenza and other respiratory viruses</Title><ISOAbbreviation>Influenza Other Respir Viruses</ISOAbbreviation></Journal><ArticleTitle>Pandemic (H1N1) 2009 influenza in Canadian pediatric cancer and hematopoietic stem cell transplant patients.</ArticleTitle><Pagination><MedlinePgn>e105-13</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1111/j.1750-2659.2012.00352.x</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">The impact of pandemic H1N1 influenza (pH1N1) virus in pediatric cancer is uncertain. The objectives of this study were to characterize the clinical course of pH1N1 and identify factors associated with severe outcomes.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">We conducted a Canadian multicenter retrospective review of children with cancer and stem cell transplant (SCT) recipients who were diagnosed with laboratory-confirmed pH1N1 infection between May 1, 2009 and January 31, 2010.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">We identified 100 (19 in wave 1 and 81 in wave 2) cases of pH1N1 infection. Median age was 8.7 years. 71% had a hematologic malignancy, and 20% received SCT. Median duration of fever and illness was 2 and 12.5 days, respectively. 51 (51.5%) were hospitalized for a median of 5 days, with no deaths and only 1 requiring admission to the intensive care unit. Radiologically confirmed pneumonia was diagnosed in 10 (10%). Interruption of chemotherapy or conditioning occurred in 43 patients. In multivariable analyses, age <5 years (relative to ≥ 10 years) and neutropenia were associated with hospitalization while neutropenia was associated with pneumonia. Despite oseltamivir use in 89%, viral shedding was prolonged (median, 46 days) and often persisted after symptom resolution. However, an extended treatment course (>5 days) correlated with shortened duration of viral shedding (P=0.041).</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">pH1N1 infection in pediatric cancer and SCT patients infrequently caused complications but commonly interrupted cancer treatment. Persistent shedding of virus after illness resolution was common. Further research is needed to verify this finding as it could have implications for treatment guidelines and infection control practices.</AbstractText><CopyrightInformation>© 2012 Blackwell Publishing Ltd.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Tran</LastName><ForeName>Dat</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Division of Infectious Diseases, The Hospital for Sick Children, Toronto, ON, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Science</LastName><ForeName>Michelle</ForeName><Initials>M</Initials></Author><Author ValidYN="Y"><LastName>Dix</LastName><ForeName>David</ForeName><Initials>D</Initials></Author><Author ValidYN="Y"><LastName>Portwine</LastName><ForeName>Carol</ForeName><Initials>C</Initials></Author><Author ValidYN="Y"><LastName>Zelcer</LastName><ForeName>Shayna</ForeName><Initials>S</Initials></Author><Author ValidYN="Y"><LastName>Johnston</LastName><ForeName>Donna L</ForeName><Initials>DL</Initials></Author><Author ValidYN="Y"><LastName>Yanofsky</LastName><ForeName>Rochelle</ForeName><Initials>R</Initials></Author><Author ValidYN="Y"><LastName>Gassas</LastName><ForeName>Adam</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Ethier</LastName><ForeName>Marie-Chantal</ForeName><Initials>MC</Initials></Author><Author ValidYN="Y"><LastName>Sung</LastName><ForeName>Lillian</ForeName><Initials>L</Initials></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>87719</GrantID><Agency>Canadian Institutes of Health Research</Agency><Country>Canada</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016448">Multicenter Study</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2012</Year><Month>03</Month><Day>14</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Influenza Other Respir Viruses</MedlineTA><NlmUniqueID>101304007</NlmUniqueID><ISSNLinking>1750-2640</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000998">Antiviral Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>20O93L6F9H</RegistryNumber><NameOfSubstance UI="D053139">Oseltamivir</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000998" MajorTopicYN="N">Antiviral Agents</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="N">administration & dosage</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002170" MajorTopicYN="N" Type="Geographic">Canada</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002648" MajorTopicYN="N">Child</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002675" MajorTopicYN="N">Child, Preschool</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018380" MajorTopicYN="Y">Hematopoietic Stem Cell Transplantation</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006776" MajorTopicYN="N">Hospitals, Pediatric</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007223" MajorTopicYN="N">Infant</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D053118" MajorTopicYN="N">Influenza A Virus, H1N1 Subtype</DescriptorName><QualifierName UI="Q000302" MajorTopicYN="Y">isolation & purification</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D007251" MajorTopicYN="N">Influenza, Human</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="N">drug therapy</QualifierName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName><QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName><QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009369" MajorTopicYN="N">Neoplasms</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="Y">complications</QualifierName><QualifierName UI="Q000628" MajorTopicYN="N">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D053139" MajorTopicYN="N">Oseltamivir</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="N">administration & dosage</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013997" MajorTopicYN="N">Time Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017201" MajorTopicYN="N">Virus Shedding</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2012</Year><Month>3</Month><Day>16</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2012</Year><Month>3</Month><Day>16</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2013</Year><Month>3</Month><Day>7</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId 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IdType="pubmed">20300571</ArticleId></ArticleIdList></Reference></ReferenceList></PubmedData></pubmed><affiliations><list><country><li>Canada</li></country></list><tree><noCountry><name sortKey="Dix, David" sort="Dix, David" uniqKey="Dix D" first="David" last="Dix">David Dix</name><name sortKey="Ethier, Marie Chantal" sort="Ethier, Marie Chantal" uniqKey="Ethier M" first="Marie-Chantal" last="Ethier">Marie-Chantal Ethier</name><name sortKey="Gassas, Adam" sort="Gassas, Adam" uniqKey="Gassas A" first="Adam" last="Gassas">Adam Gassas</name><name sortKey="Johnston, Donna L" sort="Johnston, Donna L" uniqKey="Johnston D" first="Donna L" last="Johnston">Donna L. 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