Morbidity of pandemic H1N1 influenza in children with cancer.
BACKGROUND
To define the mortality and the current impact of the H1N1 pandemic in pediatric hematology-oncology centers, we performed a specific survey.


METHODS
Pharyngeal swabs from patients with fevers of unknown origin, flu-like symptoms or bronchopneumonia were screened for H1N1 using PCR.


RESULTS
Sixty-two patients with documented H1N1 infection were reported: 16 had recently stopped therapy, 2 were at the diagnosis stage, and 44 were receiving therapy. The clinical course was severe (requiring ICU admission) in only 1 patient, moderate (requiring hospital admission) in 38, and mild in the remaining 23 (37%), treated as outpatients. While none of the patients died of H1N1-related complications, two patients died of progressive cancer; in all of the remaining cases, symptoms resolved within 11 days. The clinical course was complicated by respiratory distress or bronchopneumonia in 10 cases. Oseltamivir was given to 82% of patients. Chemotherapy was temporarily withdrawn in 54% of cases for a median time of 21 days (range, 4-43 days).


CONCLUSIONS
H1N1 infection in children with cancer was not reported as the cause of death in any case but resulted in reduced intensity of anti-cancer therapy.
Caselli
Désirée
D
Department of Pediatric Hematology Oncology, Azienda Ospedaliero-Universitaria Meyer, Florence, Italy.
Carraro
Francesca
F
Castagnola
Elio
E
Ziino
Ottavio
O
Frenos
Stefano
S
Milano
Giuseppe Maria
GM
Livadiotti
Susanna
S
Cesaro
Simone
S
Marra
Nicoletta
N
Zanazzo
Giulio
G
Meazza
Cristina
C
Cellini
Monica
M
Aricò
Maurizio
M
D000293:Adolescent; D000970:Antineoplastic Agents / Q000008:administration & dosage; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D003625:Data Collection; D004196:Disease Outbreaks; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality*; D007938:Leukemia; D008228:Lymphoma, Non-Hodgkin; D009017:Morbidity; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D016896:Treatment Outcome; D055815:Young Adult
D000970:Antineoplastic Agents