REVIEW PAPER
 
KEYWORDS
TOPICS
ABSTRACT
Introduction and objective:
Children suffering from cancer or other blood disorders have a good chance of recovery. Interruptions in treatment, however, may have a negative impact on the final outcome. External factors, such as evacuation from conflict zones, contribute to vulnerability to infections and constitute a factor for the discontinuation of therapy. The aim of the review is to present recent knowledge of catheter-related sepsis and tuberculosis (TB) in children with acute leukemia. The case is also presented of an adolescent male of Ukrainian origin. The study draws attention to the challenges in treating patients from other regions due to differences in health status.

Review methods:
The article presents a rare case report connected with a literature review, based on the Google Scholar, PubMed and Web of Science databases from recent years.

Brief description of the state of knowledge:
Many factors increase susceptibility to infections. Both leukemia itself as well as its intensive therapy influence immunosuppression. Invasive procedures disrupt physiological barriers. The presence of a central or peripheral catheter poses a main source of bloodstream infection. Deficiencies of immunity are conducive to reactivation of latent diseases such as TB, to which children are prone to develop severe forms. Therefore, treatment of latent TB infection (LTBI) in paediatric patients is crucial. In diagnosis, vigilance is particularly important in patients coming from high incidence regions with low vaccine coverage.

Summary:
Discontinuation of therapy due to infection or other external circumstances may contribute to treatment failure. Early detection is significant to prevent complications of diseases and interruptions in chemotherapy. In medical care for immigrants, the epidemiological situation of the country of origin should be taken into account.

REFERENCES (47)
1.
Agulnik A, Kizyma R, Salek M, et al. Global effort to evacuate Ukrainian children with cancer and blood disorders who have been affected by war. Lancet Haematol. 2022;9(9):645–647. https://doi.org/10.1016/S2352-....
 
2.
Shetty AK. Infectious Diseases among Refugee Children. Children (Basel). 2019;6(12):129. https://doi.org/10.3390/childr....
 
3.
Ludvigsson JF, Loboda A. Systematic review of health and disease in Ukrainian children highlights poor child health and challenges for those treating refugees. Acta Paediatr. 2022;111(7):1341–1353. https://doi.org/10.1111/apa.16....
 
4.
Stephenson J. Public Health Agency Outlines Guidance on Infectious Disease Risks for Ukrainian Refugees. JAMA Health Forum. 2022;3(3):220838. https://doi.org/10.1001/jamahe....
 
5.
Pluta M, Karny K, Lipińska M, et al. Ukrainian War Refugee Children With Particularly Severe Viral Infections: A Case Series Report. Pediatr Infect Dis J. 2024;43(2):30–36. https://doi.org/10.1097/INF.00....
 
6.
Wolf J, Tang L, Flynn PM, et al. Levofloxacin Prophylaxis During Induction Therapy for Pediatric Acute Lymphoblastic Leukemia. Clin Infect Dis. 2017;65(11):1790–1798. https://doi.org/10.1093/cid/ci....
 
7.
Quattrone M, Di Pilla A, Pagano L, et al. Infectious complications during monoclonal antibodies treatments and cell therapies in Acute Lymphoblastic Leukemia. Clin Exp Med. 2023;23(6):1823–1833. https://doi.org/10.1007/s10238....
 
8.
van de Velde ME, El Hassani SEM, Kaspers GJL, et al. Prediction of Bloodstream Infection in Pediatric Acute Leukemia by Microbiota and Volatile Organic Compounds Analysis. J Pediatr Hematol Oncol. 2022;44(1):152–159. https://doi.org/10.1097/MPH.00....
 
9.
Baier C, Linke L, Eder M, et al. Incidence, risk factors and healthcare costs of central line-associated nosocomial bloodstream infections in hematologic and oncologic patients. PLoS One. 2020;15(1):0227772. https://doi.org/10.1371/journa....
 
10.
Lafuente Cabrero E, Terradas Robledo R, Civit Cuñado A, et al. Risk factors of catheter- associated bloodstream infection: Systematic review and meta-analysis. PLoS One. 2023;18(3):0282290. https://doi.org/10.1371/journa....
 
11.
Tölle D, Hentrich M, Pelzer BW, et al. Impact of neutropenia on central venous catheter-related bloodstream infections in patients with hematological malignancies at the time of central venous catheter insertion: A matched-pair analysis. Infect Control Hosp Epidemiol. 2019;40(10):1204–1206. https://doi.org/10.1017/ice.20....
 
12.
Wolf J, Curtis N, Worth LJ, et al. Central line-associated bloodstream infection in children: an update on treatment. Pediatr Infect Dis J. 2013;32(8):905–910. https://doi.org/10.1097/INF.0b....
 
13.
Hajjar N, Ting JY, Shah PS, et al. Blood culture collection practices in NICU; A national survey. Paediatr Child Health. 2023;28(3):166–171. https://doi.org/10.1093/pch/px....
 
14.
Thaden JT, Tamma PD, Doi Y, et al. Variability in oral antibiotic step-down therapy in the management of Gram-negative bloodstream infections. Int J Antimicrob Agents. 2021;58(6):106451. https://doi.org/10.1016/j.ijan....
 
15.
Timsit JF, Ruppé E, Barbier F, et al. Bloodstream infections in critically ill patients: an expert statement. Intensive Care Med. 2020;46(2):266–284. https://doi.org/10.1007/s00134....
 
16.
Berger I, Cohen T, Rahmani E, et al. Peripheral Venous Catheter-related Bloodstream Infections in Hospitalized Children: The Role of Gram-negative Bacteria. Pediatr Infect Dis J. 2021;40(11):395–399. https://doi.org/10.1097/INF.00....
 
17.
Moriyama K, Ando T, Kotani M, et al. Risk factors associated with increased incidences of catheter-related bloodstream infection. Medicine (Baltimore). 2022;101(42):31160. https://doi.org/10.1097/MD.000....
 
18.
Supatharawanich S, Narkbunnam N, Vathana N, et al. Invasive Fungal Diseases in Children with Acute Leukemia and Severe Aplastic Anemia. Mediterr J Hematol Infect Dis. 2021;13(1):2021039. https://doi.org/10.4084/MJHID.....
 
19.
Tsai HC, Huang LM, Chang LY, et al. Central venous catheter-associated bloodstream infections in pediatric hematology-oncology patients and effectiveness of antimicrobial lock therapy. J Microbiol Immunol Infect. 2015;48(6):639–46. https://doi.org/10.1016/j.jmii....
 
20.
Gowin E, Świątek-Kościelna B, Mańkowski P, et al. The Profile of Microorganisms Responsible for Port-Related Bacteremia in Pediatric Hemato-Oncological Patients. Cancer Control. 2020;27(1):1073274820904696. https://doi.org/10.1177/107327....
 
21.
Ji L, Yang J, Miao J, et al. Infections Related to Totally Implantable Venous-Access Ports: Long-Term Experience in One Center. Cell Biochem Biophys. 2015;72(1):235–40. https://doi.org/10.1007/s12013....
 
22.
Wilczek NA, Brzyska A, Bogucka J, et al. The Impact of the War in Ukraine on the Epidemiological Situation of Tuberculosis in Europe. J Clin Med. 2023;12(20):6554. https://doi.org/10.3390/jcm122....
 
23.
Instytut Gruźlicy i Chorób Płuc. Emergency People-Centered MDR-TB Response. Accesses May 12, 2024. Available online: https://www.igichp.edu.pl/diag....
 
24.
Dahl V, Migliori GB, Lange C, et al. War in Ukraine: an immense threat to the fight against tuberculosis. Eur Respir J. 2022;59(4):2200493. https://doi.org/10.1183/139930....
 
25.
Jain A, Prakash G, Singh C, et al. Analysis of Clinical Profile and Outcome of Tuberculosis in Patients with Acute Leukemia. Indian J Hematol Blood Transfus. 2018;34(3):430–442. https://doi.org/10.1007/s12288....
 
26.
Cheng MP, Abou Chakra CN, Yansouni CP, et al. Risk of Active Tuberculosis in Patients with Cancer: A Systematic Review and Meta-Analysis. Clin Infect Dis. 2017;64(5):635–644. https://doi.org/10.1093/cid/ci....
 
27.
Vadakkan Devassy T, K V S, Jacob A, et al. Tuberculosis and childhood cancer – A review of literature. Indian J Tuberc. 2023;70(1):39–48. https://doi.org/10.1016/j.ijtb....
 
28.
van Heerden JK, van Zyl A, Schaaf HS, et al. Childhood Cancers Misdiagnosed as Tuberculosis in a High Tuberculosis Burden Setting. Pediatr Infect Dis J. 2021;40(12):1076–1080. https://doi.org/10.1097/INF.00....
 
29.
Radhakrishnan V, Sundersingh S, et al. Disseminated tuberculosis presenting as prolonged fever without source in a pediatric patient with acute lymphoblastic leukemia. J Cancer Res Ther. 2015;11(4):1043. https://doi.org/10.4103/0973-1....
 
30.
Zivanovic S, Saranac L, Kostic G, et al. A case of acute tuberculous pleuropneumonia in a patient with acute lymphoblastic leukemia. Sci World J. 2010;10:578–85. https://doi.org/10.1100/tsw.20....
 
31.
Lancioni C, LaBeaud AD, Esper F, et al. Pulmonary tuberculosis presenting as fever without source in a pediatric patient with acute lymphoblastic leukemia. Pediatr Blood Cancer. 2009;53(7):1318–20. https://doi.org/10.1002/pbc.22....
 
32.
Das A, Trehan A, Vyas S, et al. Multivertebral tubercular spondylodiscitis with abscesses in acute lymphoblastic leukemia. Pediatr Hematol Oncol. 2014;31(7):664–666. https://doi.org/10.3109/088800....
 
33.
Trisiana DY, Yani FF. Tuberculous Pleural Effusion in Child with Acute Lymphoblastic Leukemia. Science Midwifery. 2021;9(2):338–344.
 
34.
Lee JW, Kwon HJ, Jang PS, et al. Two children with differing outcomes after treatment for pulmonary tuberculosis diagnosed after allogeneic hematopoietic stem cell transplantation. Transpl Infect Dis. 2011;13(5):520–523. https://doi.org/10.1111/j.1399....
 
35.
Anwar S, Rahman AKMM, Rahman ME, et al. Bilateral Chylothorax due to Disseminated Tuberculosis and Acute Lymphoblastic Leukemia in a young boy: A case report and Literature review. Bangladesh J Child Health. 2014;38(3):164–168.
 
36.
Sahoo RK, Bakhshi S. Chylothorax at Presentation in T-Cell Acute Lymphoblastic Leukemia: The Milky Puzzle. J. Pediatr Hematol Oncol. 2014;36(8):663–4. https://doi.org/10.1097/MPH.0b....
 
37.
Iamwat W, Cheawcharnprapan K, Yenjabog P, et al. Aspergillosis and pulmonary tuberculosis co-infection in a 9-year-old with B-cell acute lymphoblastic leukemia. Oxf Med Case Reports. 2023;2023(8):omad082. https://doi.org/10.1093/omcr/o....
 
38.
Pawińska-Wa Sikowska K, Cwiklinska M, Wyrobek E, et al. Disseminated Juvenile Xanthogranuloma and Hemophagocytic Lymphohistiocytosis Developed During Treatment of Acute Lymphoblastic Leukemia: Case Report. Front Oncol. 2020;10:921. https://doi.org/10.3389/fonc.2....
 
39.
Lesaca-Medina, MY, Maramba-Lazarte C. “The Prevalence of TB infection and disease among children with acute leukemia.” PIDSP Journal. 2009;10(1):13–20.
 
40.
Cruz AT, Airewele G, Starke JR. Tuberculosis in pediatric oncology and bone marrow transplantation patients. Pediatr Blood Cancer. 2014;61(8):1484–1485. https://doi.org/10.1002/pbc.24....
 
41.
Cruz AT, Ong LT, Starke JR. Childhood pleural tuberculosis: a review of 45 cases. Pediatr Infect Dis J. 2009;28(11):981–984. https://doi.org/10.1097/INF.0b....
 
42.
Viswanathan VK. Latent TB infection in children and adolescents: Scientific rationale and programmatic management. Indian J Tuberc. 2023;70(1):35–38. https://doi.org/10.1016/j.ijtb....
 
43.
Hasan T, Au E, Chen S, et al. Screening and prevention for latent tuberculosis in immunosuppressed patients at risk for tuberculosis: a systematic review of clinical practice guidelines. BMJ Open. 2018;8(9):022445. https://doi.org/10.1136/bmjope....
 
44.
Taha R, Kothari S, Foroutan F, et al. Implementation of a Routine Screening Program for Latent Tuberculosis Infection among Patients with Acute Leukemia at a Canadian Cancer Center. Curr Oncol. 2022;29(12):9325–9334. https://doi.org/10.3390/curron....
 
45.
Chin KL, Anibarro L, Sarmiento ME, et al. Challenges and the Way forward in Diagnosis and Treatment of Tuberculosis Infection. Trop Med Infect Dis. 2023;8(2):89. https://doi.org/10.3390/tropic....
 
46.
Pelosi U, Pintus R, Savasta S, et al. Pulmonary Tuberculosis in Children: A Forgotten Disease? Microorganisms. 2023;11(7):1722. https://doi.org/10.3390/microo....
 
47.
Rodrigues C, Singhal T. What is New in the Diagnosis of Childhood Tuberculosis? Indian J Pediatr. 2024;91(7):717–723. https://doi:10.1007/s12098-023....
 
eISSN:1898-2263
ISSN:1232-1966
Journals System - logo
Scroll to top