Viral infections in pediatric brain tumor patients treated with targeted therapies.

CNS infection SARS-CoV-2 brain tumor pediatric targeted therapies viral infection

Journal

Pediatric blood & cancer
ISSN: 1545-5017
Titre abrégé: Pediatr Blood Cancer
Pays: United States
ID NLM: 101186624

Informations de publication

Date de publication:
01 2023
Historique:
revised: 31 08 2022
received: 30 06 2022
accepted: 29 09 2022
pubmed: 30 10 2022
medline: 30 11 2022
entrez: 29 10 2022
Statut: ppublish

Résumé

Brain tumors are the most common solid malignancies and the leading cause of cancer-related mortality in children. While numerous studies report on viral infections in children with hematologic malignancies and solid organ transplantation, epidemiologic data on the incidence and outcome of viral infections in pediatric patients with brain tumors treated with targeted therapies are still lacking. We retrospectively reviewed all children with brain tumors receiving targeted therapies in a primary or recurrent setting at the Medical University of Vienna from 2006 to 2021. Demographic variables, quantitative and qualitative parameters of possible infections, and treatment outcomes were recorded. In our cohort (n = 117), 36% of the patients developed at least one PCR-proven viral infection. Respiratory and gastrointestinal tract infections were most common, with 31% and 25%, respectively. Central nervous system (CNS) infections occurred in approximately 10%, with an almost equal distribution of varicella-zoster virus, John Cunningham virus (JCV), and enterovirus. Two patients tested PCR-positive for SARS-CoV-2 infection, with one virus-related death caused by a SARS-CoV-2-related acute respiratory distress syndrome. Patients receiving bevacizumab or mTOR inhibitors seem to have a greater susceptibility to viral infections. Pediatric patients with brain tumors receiving targeted therapies have a higher risk of viral infections when compared to children receiving conventional chemotherapy or the general population, and life-threatening infections can occur. Fast detection and upfront treatment are paramount to prevent life-threatening infections in immunocompromised children suffering from brain tumors receiving targeted therapies.

Sections du résumé

BACKGROUND
Brain tumors are the most common solid malignancies and the leading cause of cancer-related mortality in children. While numerous studies report on viral infections in children with hematologic malignancies and solid organ transplantation, epidemiologic data on the incidence and outcome of viral infections in pediatric patients with brain tumors treated with targeted therapies are still lacking.
OBJECTIVES/STUDY DESIGN
We retrospectively reviewed all children with brain tumors receiving targeted therapies in a primary or recurrent setting at the Medical University of Vienna from 2006 to 2021. Demographic variables, quantitative and qualitative parameters of possible infections, and treatment outcomes were recorded.
RESULTS
In our cohort (n = 117), 36% of the patients developed at least one PCR-proven viral infection. Respiratory and gastrointestinal tract infections were most common, with 31% and 25%, respectively. Central nervous system (CNS) infections occurred in approximately 10%, with an almost equal distribution of varicella-zoster virus, John Cunningham virus (JCV), and enterovirus. Two patients tested PCR-positive for SARS-CoV-2 infection, with one virus-related death caused by a SARS-CoV-2-related acute respiratory distress syndrome. Patients receiving bevacizumab or mTOR inhibitors seem to have a greater susceptibility to viral infections.
CONCLUSION
Pediatric patients with brain tumors receiving targeted therapies have a higher risk of viral infections when compared to children receiving conventional chemotherapy or the general population, and life-threatening infections can occur. Fast detection and upfront treatment are paramount to prevent life-threatening infections in immunocompromised children suffering from brain tumors receiving targeted therapies.

Identifiants

pubmed: 36308741
doi: 10.1002/pbc.30065
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e30065

Commentaires et corrections

Type : CommentIn
Type : CommentIn

Informations de copyright

© 2022 The Authors. Pediatric Blood & Cancer published by Wiley Periodicals LLC.

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Auteurs

Lisa Mayr (L)

Department of Pediatrics and Adolescent Medicine, Comprehensive Cancer Center for Pediatrics, Medical University of Vienna, Vienna, Austria.

Tobias Steinmaurer (T)

Department of Pediatrics and Adolescent Medicine, Comprehensive Cancer Center for Pediatrics, Medical University of Vienna, Vienna, Austria.

Lukas Weseslindtner (L)

Center for Virology, Medical University of Vienna, Vienna, Austria.

Sibylle Madlener (S)

Department of Pediatrics and Adolescent Medicine, Comprehensive Cancer Center for Pediatrics, Medical University of Vienna, Vienna, Austria.

Robert Strassl (R)

Department of Virology, Medical University of Vienna, Vienna, Austria.

Johannes Gojo (J)

Department of Pediatrics and Adolescent Medicine, Comprehensive Cancer Center for Pediatrics, Medical University of Vienna, Vienna, Austria.

Amedeo A Azizi (AA)

Department of Pediatrics and Adolescent Medicine, Comprehensive Cancer Center for Pediatrics, Medical University of Vienna, Vienna, Austria.

Irene Slavc (I)

Department of Pediatrics and Adolescent Medicine, Comprehensive Cancer Center for Pediatrics, Medical University of Vienna, Vienna, Austria.

Andreas Peyrl (A)

Department of Pediatrics and Adolescent Medicine, Comprehensive Cancer Center for Pediatrics, Medical University of Vienna, Vienna, Austria.

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