Pediatric Leukemia Treatment Linked to Increased Risk of Infections, Study Finds

A history of leukemia therapy during childhood may be associated with an increased risk of infections, according to a recent study published by the Journal of Clinical Oncology.

The researchers aimed to investigate infectious risk in survivors of childhood leukemia by comparing the relative rate of infections of childhood leukemia survivors following the end of treatment and the general population.

A retrospective, population-based cohort study was conducted with children diagnosed with leukemia between 1992 and 2015 who were alive and relapse free 30 days following treatment completion. The survivors were matched at a 5:1 ratio to the general population by birth year, sex, and urban/rural status and then stratified by initial treatment, including and excluding hematopoietic stem-cell transplantation (HSCT), according to the research.

In total, 2204 leukemia survivors were matched with 11,020 controls. Compared with controls, the rate of infections for survivors was higher after treatment completion and at less than 1 year, 1 to 4.99 years, and 5 or more years. Of those whose initial treatment excluded HSCT, the rate remained elevated more than 5 years after the treatment completion, the study found.

Additionally, the study found that infection-related death was significantly increased in all leukemia survivors, but also those without HSCT.

“An understanding of the risks for infection after therapy completion is important because it will guide recommendations for care during this period, including counselling for patients and families and re-immunization practices and medical care for leukemia survivors who present with signs or symptoms of infections,” the authors noted.

The researchers call for additional studies on this link between pediatric leukemia and infections. The studies should focus on establishing which specific exposures in patients with leukemia lead to infections later on, according to the research.

Reference

Pelland-Marcotte M, Pole J, Hwee J, et al. Long-term risk of infections after treatment of childhood leukemia: A population-based cohort study using administrative health data [published online August 8, 2019]. Journal of Clinical Oncology. doi.org/10.1200/JCO.19.00570