Severe infections following treatment for childhood cancer: a report from CYP-C

Abstract

Little is known about infections occurring after childhood cancer treatment. We assessed the risk of severe infection postcancer therapy in survivors of leukemia compared to other cancer types. We performed a population-based cohort study of children <15 years of age diagnosed with cancer (2001–2016), alive and relapse-free 30 days after treatment completion. The risk of severe infection in both groups was estimated using subdistribution proportional hazard regression. We identified 6148 survivors (1960 with leukemia). The cumulative incidence (95% confidence interval) of severe infections at 3 years was 0.70% (0.40–1.2%) in leukemia and 0.51% (0.32–0.79%) in other cancers. The risk of severe infection was not statistically different in leukemia survivors compared to other cancer types in univariate and multivariate analysis (adjusted hazard ratio: 1.40, 95% CI: 0.69–2.85). No significant association was found between a history of leukemia and an increased risk of severe infection after treatment, compared to other cancer types.

Keywords:

• Leukemia
• children
• survivors
• infections

Acknowledgements

The authors gratefully acknowledge the contributions of study participants, participating pediatric oncology centers, members of the Cancer in Young People in Canada (CYP-C) Management and Advisory Committees, and the Pediatric Oncology Group of Ontario (POGO). We also thank Dr Marie-Claude Rousseau and Dr Nick Daneman, who reviewed a previous version of this text. Data used in this publication are from the Cancer in Young People in Canada Surveillance Program and are used with the permission of the Public Health Agency of Canada. The analyses and interpretation presented in this work do not necessarily reflect the opinions of the federal government of Canada.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

Marie-Claude Pelland-Marcotte received support from a Canadian Institutes of Health Research (CIHR) Doctoral Research Award, under the grant [HMD-164883].