Children With ALL in Maintenance Therapy and COVID-19 Have Fewer Hospitalizations, ICU Admissions 

Among children with cancer experiencing COVID-19, a recent study showed children with acute lymphoblastic leukemia in maintenance therapy (ALL-MTN) had fewer hospitalizations and admissions to an intensive care unit (ICU) than other children with cancer did. However, children in ALL-MTN also underwent more treatment modifications than others did. Study findings were reported in the journal JCO^® Oncology Practice.

The study was an analysis of the Pediatric Oncology COVID-19 Case Report, evaluating deidentified sociodemographic and clinical data for children, adolescents, and young adults in the US who have cancer and COVID-19. In this analysis, researchers evaluated a variety of outcomes related to COVID-19 for patients aged 21 years and younger in ALL-MTN, compared with patients of this age group having other forms of cancer.

In this analysis, 481 patients were in ALL-MTN, compared with 1190 patients having other forms of cancer. Patients in ALL-MTN had a mean age at COVID-19 infection of 9.5 years (SD, 5.5), compared with a mean age of 9.6 years (SD, 6.1) for patients with other forms of cancer. COVID-19–directed therapy was used with 15.8% of patients in ALL-MTN and in 15.7% of patients with other forms of cancer. 

Rates of hospitalization were 23% with ALL-MTN, compared with 29% with other forms of cancer (P =.01). Additionally, rates of ICU admissions were 3% with ALL-MTN, compared with 5% with other forms of cancer (P =.01). 

There were no deaths reported among children with ALL-MTN, while 2.4% of other patients in the cohort had died (P =.0006). Of the 29 deaths among these patients, 7 were attributed to COVID-19 and 7 were attributed to cancer and COVID-19.

In multivariable analysis, the odds ratio (OR) for hospitalization was 0.7 (95% CI, 0.6-0.9) for patients in ALL-MTN compared with other forms of cancer. For ICU admission, the OR for this comparison was 0.5 (95% CI, 0.2-0.8). Overall, vaccination was associated with reducing the odds of hospitalization, compared with not being vaccinated (OR, 0.7; 95% CI, 0.5-0.9). 

Changes in cancer-directed therapy more often for patients in ALL-MTN (50.1%) than for patients with other forms of cancer (32.6%; P <.0001). The OR for this comparison was 2.0 (95% CI, 1.6-2.5). Changes in therapy for patients in ALL-MTN most commonly involved delays in chemotherapy. 

“In summary, in the setting of COVID-19, children in ALL-MTN have high rates of hospital admission, ICU admission, and changes in their cancer-directed therapy, but odds of hospitalization, ICU admission, and death are lower than those of other children with cancer,” the researchers wrote in their report. However, they also noted that children in ALL-MTN experience higher morbidity associated with COVID-19 than observed in the general pediatric population.

Disclosures: Some authors have declared affiliations with or received grant support from the pharmaceutical industry. Please refer to the original study for a full list of disclosures.

This article originally appeared on Hematology Advisor