Journal article
COVID-19 Disease in Children With ALL Receiving Maintenance Therapy: Do Not Discount the Risk
JCO oncology practice, Vol.20(12), pp.1655-1662
12/2024
DOI: 10.1200/OP.23.00631
PMID: 39159420
Abstract
Unlike most childhood cancers, therapy for ALL includes a prolonged maintenance phase during which children typically resume regular activities. Physicians need data regarding the persistent impact of COVID-19 in this population to help guide families after the pandemic.PURPOSEUnlike most childhood cancers, therapy for ALL includes a prolonged maintenance phase during which children typically resume regular activities. Physicians need data regarding the persistent impact of COVID-19 in this population to help guide families after the pandemic.The Pediatric Oncology COVID-19 Case Report (POCC) collects deidentified data (sociodemographics, clinical data [cancer, COVID-19 course]) on children, adolescents, and young adults with cancer and COVID-19 from 104 US pediatric oncology institutions. The analysis presented here compares children (≤21 years) with ALL in maintenance (ALL-MTN) with all other children with cancer and COVID-19. Multivariable analyses adjust for age, race/ethnicity, insurance, absolute neutrophil count at the time of infection, vaccination, and comorbidities.METHODSThe Pediatric Oncology COVID-19 Case Report (POCC) collects deidentified data (sociodemographics, clinical data [cancer, COVID-19 course]) on children, adolescents, and young adults with cancer and COVID-19 from 104 US pediatric oncology institutions. The analysis presented here compares children (≤21 years) with ALL in maintenance (ALL-MTN) with all other children with cancer and COVID-19. Multivariable analyses adjust for age, race/ethnicity, insurance, absolute neutrophil count at the time of infection, vaccination, and comorbidities.Compared with other children reported to POCC (n = 1,190), those in ALL-MTN (n = 481) were less often hospitalized (23% v 29%, P = .01) or admitted to the intensive care unit (ICU: 3% v 5%, P = .01); these findings persisted in multivariable analysis (hospitalization: odds ratio [OR], 0.7 [95% CI, 0.6 to 0.9]; ICU: OR, 0.5 [95% CI, 0.2 to 0.8]). However, cancer-directed therapy was changed more often for children in ALL-MTN (50% v 33%, P ≤ .01; OR, 2.0 [95% CI, 1.6 to 2.5[). Vaccination was an independent prognostic factor in our multivariable model, decreasing odds of hospitalization (OR, 0.7 [95% CI, 0.5 to 0.9]).RESULTSCompared with other children reported to POCC (n = 1,190), those in ALL-MTN (n = 481) were less often hospitalized (23% v 29%, P = .01) or admitted to the intensive care unit (ICU: 3% v 5%, P = .01); these findings persisted in multivariable analysis (hospitalization: odds ratio [OR], 0.7 [95% CI, 0.6 to 0.9]; ICU: OR, 0.5 [95% CI, 0.2 to 0.8]). However, cancer-directed therapy was changed more often for children in ALL-MTN (50% v 33%, P ≤ .01; OR, 2.0 [95% CI, 1.6 to 2.5[). Vaccination was an independent prognostic factor in our multivariable model, decreasing odds of hospitalization (OR, 0.7 [95% CI, 0.5 to 0.9]).Children in ALL-MTN required fewer hospitalizations and ICU admissions but more therapy modifications than other children with cancer. Vaccination against COVID-19 reduced the odds of hospitalization.CONCLUSIONChildren in ALL-MTN required fewer hospitalizations and ICU admissions but more therapy modifications than other children with cancer. Vaccination against COVID-19 reduced the odds of hospitalization.
Details
- Title: Subtitle
- COVID-19 Disease in Children With ALL Receiving Maintenance Therapy: Do Not Discount the Risk
- Creators
- Alissa R Kahn - St. Joseph’s University Medical CenterElizabeth S Davis - Boston Medical CenterChen Dai - University of Alabama at BirminghamCaroline V Caudill - University of Alabama at BirminghamIsaac Martinez - University of Alabama at BirminghamJulienne Brackett - University of Alabama at BirminghamArchana Sharma - Texas Children's HospitalCarla Schwalm - Rutgers, The State University of New JerseyAnn KebedeDavid S Dickens - University of IowaJoshua Richman - University of Alabama at BirminghamSusan Colace - University of Alabama at BirminghamBrook Araya - Boston Medical CenterSmita Bhatia - University of Alabama at BirminghamJulie A Wolfson - University of Alabama at BirminghamJennifer M Levine - Center for Cancer and Blood DisordersEmily E Johnston - University of Alabama at BirminghamPediatric Oncology COVID-19 Case Report (POCC) Consortium
- Resource Type
- Journal article
- Publication Details
- JCO oncology practice, Vol.20(12), pp.1655-1662
- Publisher
- LIPPINCOTT WILLIAMS & WILKINS
- DOI
- 10.1200/OP.23.00631
- PMID
- 39159420
- ISSN
- 2688-1535
- eISSN
- 2688-1535
- Grant note
- Concern Foundation
Supported by the Concern Foundation.
- Language
- English
- Electronic publication date
- 08/19/2024
- Date published
- 12/2024
- Academic Unit
- Stead Family Department of Pediatrics; Hematology/Oncology
- Record Identifier
- 9984697760102771
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