COVID-19 Disease in Children With ALL Receiving Maintenance Therapy: Do Not Discount the Risk
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Published:2024-08-19
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ISSN:2688-1527
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Container-title:JCO Oncology Practice
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language:en
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Short-container-title:JCO Oncol Pract
Author:
Kahn Alissa R.1, Davis Elizabeth S.2ORCID, Dai Chen3, Caudill Caroline V.3, Martinez Isaac3, Brackett Julienne3ORCID, Sharma Archana4, Schwalm Carla5, Kebede Ann6ORCID, Dickens David S.7ORCID, Richman Joshua38ORCID, Colace Susan9ORCID, , Araya Brook2, Bhatia Smita39ORCID, Wolfson Julie A.39ORCID, Levine Jennifer M.10ORCID, Johnston Emily E.39ORCID, Aftandilian Catherine, Agrawal Anurag K., De Angulo Guillermo, Aristizabal Paula, Bailey Kayleen, Bardwell Jenna K., Becton David L., Bemrich-Stolz Christina J., Boal Lauren H, Boston Catherine W.H., Bradfield Scott M., Caywood Emi H., Cohn Shannon M., Colace Susan I., Coven Scott L., Cramer Stuart L., Cuglievan Branko, Dargart Jamie L., Daghistani Doured, Dhir Aditi, Dickens David S., Dumitriu Anca, Eslin E., Esquilin Jose M., Feinberg Shari L., Ferdjallah Asmaa, Fernandez Karen S., Fixler Jason, Foley Jessica M., Gampel Bradley H., Glasser Chana L., Goodman Jessica F., Gotesman Moran, Gowans L. Kate, Gupta Ajay, HaDuong Josephine H., Halpern Steven L., Hara Harneet K., Hartman Lisa R., Herring Katye L., Hesko Caroline S., Aguayo-Hiraldo Paibel, Hoeft Alice K., Hu Caroline Y., Huo Jeffrey S., Ikeda Alan K., Isakoff Michael S., Jain Akshat, Kahn Alissa R., Kothari Prachi D., Krajewski Jennifer A., Kram David E., MCR , Krystal Julie I., Kyono Wade T., Langevin Mary A., CFNP , Hayes-Lattin Brandon, Law Jason, Levine Jennifer M, Lorenzana Adonis Napoleon, Lotterman Craig D., Majlessipour Fataneh, Marri Preethi R., Massey Gita V., Monteleone Philip M., Moskop Amy M., Mowbray Catriona, CPHON , Navalkele Pournima D., Olson Janice F., Ostrodka Leanne, O’suoji Chibuzo C., Patel Pratik A., Pawlowska Anna, Perl Anna Sechser, Pinchinat Ashley E., Prasad Pinki K., Rangaswami Arun Atreiya, Raulji Chittalsinh M., Rico Juan Felipe, Saha Aniket, Salman Emad Kassim, SantaCruz Nadine P., Sarangi Susmita N., Schwalm Carla M., Sharma Archana, Shaw Peter H., Simon David C., Slayton William B., Smith Amy A., Smitherman Andrew B., Sorge Caryn E., Sun Jessica M., Symons Heather J., Tal Adit, Thomas Stefanie M., Tran Hung C., Troutman Jacob A., Turcotte Lucie M., Valdez Jessica M., Varela Carly R., Whipple Nicholas S., Wilkes Jennifer J., Woods-Swafford Wendy, Yim Yung S., Zhang Yaoping
Affiliation:
1. Pediatric Hematology-Oncology, Department of Pediatrics, Saint Joseph's University Medical Center, Paterson, NJ 2. Department of Surgery, Boston University/Boston Medical Center, Boston, MA 3. University of Alabama at Birmingham, Institute for Cancer Outcomes and Survivorship, Birmingham, AL 4. Pediatric Hematology-Oncology, Department of Pediatrics, Texas Children's Hospital, Houston, TX 5. Pediatric Hematology-Oncology, Department of Pediatrics, Rutgers Cancer Institute, New Brunswick, NJ 6. Pediatric Hematology-Oncology, Department of Pediatrics, Bronson Methodist Hospital, Kalamazoo, MI 7. Pediatric Hematology-Oncology, Nationwide Children's Hospital, Columbus, OH 8. Department of Surgery, University of Alabama at Birmingham, Birmingham, AL 9. Pediatric Hematology-Oncology, Department of Pediatrics, University of Alabama at Birmingham 10. Center for Cancer and Blood Disorders, Division of Oncology, Children's National Medical Center
Abstract
PURPOSE 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. METHODS 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. RESULTS 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]). CONCLUSION 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.
Publisher
American Society of Clinical Oncology (ASCO)
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