SARS COV-2 Infection in Children with Leukemia

Öz

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) directed great attention and anxiety all over the world. Epidemiologic models predict that the current COVID-19 pandemic will last several months or even several years, until the development of a vaccine and/or herd immunity. Although the course of the infection is often not severe in children, it can be life threatening especially in immunocompromised children with leukemia. Hematopoietic and lymphoid cancers are accounting for approximately 40% of all childhood cancers. The five-year survival rate for childhood cancer has approached to 70% and more than 80% for leukemia in our country. During COVID pandemic, children with leukemia may also have COVID-19 infection, especially when their bone marrow is depressed due to chemotherapy. It is observed that factors such as the underlying type of cancer, status of remission, or having stem cell transplantation may affect the prognosis. As well as standard and proven treatments for febrile neutropenia, all tests and treatments should be applied very quickly and properly for COVID 19 as is all suspected patients. These efforts may contribute to increase the survival of our children with cancer. Given the absence of data to address concerns related to SARS-CoV-2 infection while on chemotherapy, questions are increasing about the approach for management of systemic immunosuppressive therapies, i.e. ceasing or reducing the immunosuppressive medications in children with leukemia. The current rapid worldwide spread of COVID-19 necessitates identifying optimal preventive strategies and effective medical management. In this report, we tried to review appropriate literature-based approaches for prevention, diagnosis and management of treatment protocols for children with cancer during the pandemic period.

Anahtar Kelimeler

• SARS COV-2 infection
• children with leukemia
• medical management

Lösemili Çocuklarda SARS COV-2 Enfeksiyonu

Öz

Şiddetli akut solunum sendromu koronavirüs 2 (SARS-CoV-2) tüm dünyada dikkatle ve kaygıyla izlenmektedir. Epidemiyolojik modeller, mevcut COVID-19 pandemisinin bir aşı ve / veya sürü bağışıklığı gelişene kadar birkaç ay hatta birkaç yıl süreceğini tahmin etmektedir. Çocuklarda COVID-19 enfeksiyonu genellikle hafif seyretmekle birlikte, özellikle bağışıklığı zayıflamış lösemili çocuklarda hayatı tehdit edebilir. Hematopoetik ve lenfoid kanserler tüm çocukluk çağı kanserlerinin yaklaşık % 40'ını oluşturmaktadır. Çocukluk çağı kanserlerinde ülkemizde beş yıllık sağkalım oranı % 70'e ve lösemi için bu oran % 80'e ulaşmıştır. COVID-19 salgını sırasında, lösemili çocuklarda, özellikle kemoterapi nedeniyle kemik iliğinin baskılandığı dönemde, COVID-19 enfeksiyonuna yakalanma riski yüksek olabilir. Altta yatan kanser türü, kanserin remisyon durumu veya kök hücre nakli yapılmış olması gibi faktörler de enfeksiyona cevabı etkileyebilir. Nötropenik ateşli hastalarda, standart ve kanıtlanmış tedavilerin yanı sıra, COVID 19 için şüpheli hastalarda olduğu gibi tüm testler ve tedaviler çok hızlı ve uygun bir şekilde uygulanmalıdır. Bu çabalar kanserli çocuklarımızın hayatta kalma oranını arttırmaya katkıda bulunacaktır. Kemoterapisi devam eden hastalarda SARS-CoV-2 enfeksiyonu ile ilgili verilerin yeterli olmaması nedeniyle, lösemili çocuklar gibi sistemik immünsüpresif tedavileri devam etmesi gereken hastalarda, immünosüpresif tedavinin azaltılması veya ertelenmesi gibi sorulara cevap aranmaktadır. COVID-19'un dünya çapında hızla yayılması, hastalıktan korunmak için gerekli stratejilerin ve etkin tıbbi tedavilerin geliştirilmesiniı gerektirmektedir. Bu yazıda pandemi döneminde lösemili çocuklarda gelişebilecek COVID-19'un önlenmesi, tanı koyulması ve enfeksiyon geliştiğinde tedavi protokollerine yönelik literature dayalı uygun yaklaşımları derlemeye çalıştık.

Anahtar Kelimeler

• SARS COV-2 enfeksiyonu
• lösemili çocuklar
• tıbbi tedavi

Kaynakça

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