title: Morbidity of pandemic H1N1 influenza in children with cancer.
abstract: 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 Chemotherapy was temporarily withdrawn in 54% of cases for a median time of 21 days (range, 4-43 days).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.
authors.affiliation: Department of Pediatric Hematology Oncology, Azienda Ospedaliero-Universitaria Meyer, Florence, Italy.
authors.forename: Désirée
authors.initials: D
authors.lastname: Caselli
authors.forename: Francesca
authors.initials: F
authors.lastname: Carraro
authors.forename: Elio
authors.initials: E
authors.lastname: Castagnola
authors.forename: Ottavio
authors.initials: O
authors.lastname: Ziino
authors.forename: Stefano
authors.initials: S
authors.lastname: Frenos
authors.forename: Giuseppe Maria
authors.initials: GM
authors.lastname: Milano
authors.forename: Susanna
authors.initials: S
authors.lastname: Livadiotti
authors.forename: Simone
authors.initials: S
authors.lastname: Cesaro
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Marra
authors.forename: Giulio
authors.initials: G
authors.lastname: Zanazzo
authors.forename: Cristina
authors.initials: C
authors.lastname: Meazza
authors.forename: Monica
authors.initials: M
authors.lastname: Cellini
authors.forename: Maurizio
authors.initials: M
authors.lastname: Aricò
mesh_terms: 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
chemical_list: D000970:Antineoplastic Agents