Akademik Veri Yönetim Sistemi
XIV Internatıonal Eurasian Hematology-Oncology Congress, İstanbul, Türkiye, 11 - 14 Ekim 2023, cilt.45, sa.3, ss.29
Objective: Respiratory viruses are an important cause of morbidity and mortality in pediatric hematology oncology
patients. We aimed to determine the infection rate, clinical
and epidemiological characteristics of respiratory viruses in
pediatric patients with hemato-oncological malignancy,
aplastic anemia and congenital neutropenia and to show how
these viruses affect the primary disease course and treatment. Methodology: Between August 2015 and December
2018, 97 patients aged between 5 months and 215 months
who were admitted to Istanbul University, Istanbul Faculty of
Medicine, Department of Pediatric Haematology-Oncology
with acute respiratory tract infection findings and diagnosed
with Haemato-Oncological Malignancy, Congenital Neutropenia, Aplastic Anaemia and who had viral respiratory panel
were retrospectively analysed. In the viral respiratory panel
test, nasal swab samples of the patients were evaluated by
RT-multiplex PCR method. SPSS (Statistical Package for the
Social Sciences) 22.0 programme was used for statistical analyses Results: A total of 97 patients, 52 males (53.6%) and 45
females (46.4%), aged between 5 months and 215 months
(78.81§60.17 months, median 60 months) were included in
the study. The most common viral respiratoty panel (VRP)
positivity was observed between 5 months and 208 months
and the mean age was 85.49§61.73 months (median=81
months). Although 44.3% (n=43) of the patients presented in
winter and 23.7% (n=23) in autumn, VRP positivity was more
common in patients presenting in spring (n=43, 70%) and winter (n=22, 51.2%) seasons. When the VRP results of the
patients were analysed; 50.5% (n=49) were positive; 39.2%
(n=38) were monoinfection, 11.3% (n=11) were co-infection)
and 49.5% (n=48) were negative. When we looked at the VRP
results, rhinovirus (hRV) was the most common virus with a
frequency of 22.4% (n=11). Other viruses were Respiratory
Synsititial Virus (RSV) A/B (14.2% n=7), Parainfluenza (14.2%
n=7), Influenza (8.2% n=4), Coronavirus (8.2% n=4), Metapneumovirus (2.1% n=1), Mycoplasma pneumonia (6.1% n=3).
Among the co-infections seen in a total of 11 patients, hRV
and RSV A/B were the most common viruses accompanying
other viruses with a rate of 63.6% (n=7). Among a total of 67
patients who were in various stages of CT and whose treatment was completed, the most common VRP positivity was
seen in patients in the induction phase with a rate of 28.3%
(n=19). Of the 12 patients with co-infection, 5 (41.6%) were in
the induction phase. Cough (n=59 60.8%) and fever (n=47
48.5%) were the most common presenting complaints,
accompanied by wheezing (n=17 17 17.5%), respiratory distress (n=11 11.3%), diarrhoea/vomiting (n=9 9.3%) and muscle
pain (n=9 9.3%). VRP was positive in 43.9% of patients presenting with fever. The most common hRV virus was found most
frequently in spring and winter seasons. Viral respiratory
infection positivity was most frequently seen in ALL (n=16
33.3%), second most frequently in Hodgkin's Lymphoma (n=5
10.5%) and Neuroblastoma (n=5 10.5%). Among the patients,
upper respiratory tract infection (URTI) (74.2%, n=72) was
more common than lower respiratory tract infection (LRTI)
(25.8%, n=25). The rate of LRTI in co-infections (28.0%, n=14)
was higher than the rate of URTI (6.9%, n=5) and was statistically significant (p=0.021). When hemogram and biochemistry
results were analysed, although neutropenia (50.5%) and lymphopenia (50.5%) were observed at a high rate in patients
with positive VRI, they were not statistically significant when
compared with VRP positivity. Of the patients with VRP positivity (50.5% n=49), 34.6% (n=17) required hospitalisation due
to viral respiratory infection. Of the patients included in the
study, 4 patients need intensive care unit due to bacterial
pneumonia (Mycoplasma pneumonia and Pneumocystis jireovici), bleeding into a mass (hepatoblastoma) and pericardial
effusion (peripheric T cell lymphoma). In 7 patients whose
chemotherapy duration was prolonged, the duration of treatment prolongation ranged between 4 and 60 days (mean
19.29§20.69 and median 10 days). No VRI-related mortality
was observed among the patients during the follow-up
period. Conclusion: Identification of respiratory viruses in
pediatric hematology oncology patients contributes to the
management of their primary disease.
https://doi.org/10.1016/j.htct.2023.09.048