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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Risk factors for severe respiratory syncytial virus disease in children with cancer: the importance of lymphopenia and young age.
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Risk factors for severe respiratory syncytial virus disease in children with cancer: the importance of lymphopenia and young age.

机译：癌症患儿严重呼吸道合胞病毒疾病的危险因素：淋巴细胞减少症和年轻年龄的重要性。

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OBJECTIVE: We sought to determine the epidemiologic features of respiratory syncytial virus infection in immunocompromised pediatric patients and to identify the risk factors for severe disease. METHODS: We designed a retrospective study examining the experience with respiratory syncytial virus infection in pediatric patients with underlying malignancies and hematopoietic stem cell transplant recipients seen between 1997 and 2005. Clinical and laboratory data were extracted from patient records, and independent predictors of disease severity were investigated. RESULTS: Fifty-eight patients met the study criteria. Twenty-three patients (40%) had underlying diagnoses of acute lymphoblastic leukemia, 11 (19%) had solid tumors, and 24 (41%) were hematopoietic stem cell transplant recipients, had acute myeloid leukemia, or had severe combined immunodeficiency syndrome. Seventeen patients (29%) were < 2 years of age. Overall, 16 patients (28%) developed lower respiratory tract infections. The frequency of lower respiratory tract infections was highest in patients with hematopoietic stem cell transplants, acute myeloid leukemia, or severe combined immunodeficiency syndrome (42%). Independent predictors of lower respiratory tract infections were profound lymphopenia, with absolute lymphocyte counts of < 100 cells per mm3, and age of < or = 2 years. Of all patients with lower respiratory tract infections, 31% died as a result of respiratory syncytial virus infection. The overall mortality rate was low (5 of 58 patients; 8.6%). All deaths occurred in patients with lower respiratory tract infections who were before or after hematopoietic stem cell transplants or were < 2 years of age and receiving treatment for acute myeloid leukemia. Neutropenia was not a predictor of respiratory syncytial virus lower respiratory tract infection or death. CONCLUSIONS: This study identified profound lymphopenia and young age as independent predictors of respiratory syncytial virus-related lower respiratory tract infections in immunocompromised children. No association between neutropenia and respiratory syncytial virus-related morbidity or death was found. These findings can guide interventions for respiratory syncytial virus infection in high risk hosts.
机译：目的：我们试图确定免疫受损的小儿患者呼吸道合胞病毒感染的流行病学特征，并确定严重疾病的危险因素。方法：我们设计了一项回顾性研究，调查了1997年至2005年间患基础恶性肿瘤和造血干细胞移植的小儿患者的呼吸道合胞病毒感染的经历。调查。结果：58例患者符合研究标准。有23例（40％）的患者被诊断出患有急性淋巴细胞白血病，有11例（19％）患有实体瘤，有24例（41％）是造血干细胞移植患者，患有急性髓性白血病或患有严重的免疫缺陷综合症。 17岁以下的患者（29％）小于2岁。总体而言，有16名患者（28％）出现了下呼吸道感染。在造血干细胞移植，急性髓细胞性白血病或严重的合并免疫缺陷综合症患者中，下呼吸道感染的频率最高（42％）。下呼吸道感染的独立预测因素是严重的淋巴细胞减少，绝对淋巴细胞计数<100个细胞/ mm3，年龄<或= 2岁。在所有下呼吸道感染患者中，有31％因呼吸道合胞病毒感染而死亡。总体死亡率较低（58名患者中有5名; 8.6％）。所有死亡均发生在造血干细胞移植之前或之后或<2岁并接受急性髓样白血病治疗的下呼吸道感染患者中。中性粒细胞减少症不是呼吸道合胞病毒下呼吸道感染或死亡的预测指标。结论：这项研究确定了免疫力低下的儿童中，严重的淋巴细胞减少和年轻人是呼吸道合胞病毒相关的下呼吸道感染的独立预测因子。在中性粒细胞减少症和呼吸道合胞病毒相关的发病率或死亡之间未发现关联。这些发现可以指导高危宿主呼吸道合胞病毒感染的干预措施。

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