Get access

Does school attendance during initial cancer treatment in childhood increase the risk of infection?

Authors

  • Margareta af Sandeberg RN, PhD,

    Corresponding author
    1. Department of Pediatric Hematology and Oncology, Karolinska University Hospital, Stockholm, Sweden
    • Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
    Search for more papers by this author
  • Lena Wettergren RN, PhD,

    1. Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
    Search for more papers by this author
  • Olle Björk MD, PhD,

    1. Department of Women's and Children's Health, Childhood Cancer Research Unit, Karolinska Institutet, Stockholm, Sweden
    Search for more papers by this author
  • Johan Arvidson MD, PhD,

    1. Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
    Search for more papers by this author
  • Eva Johansson RN, PhD

    1. Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
    2. Department of Medicine, Karolinska Institutet, Stockholm, Sweden
    Search for more papers by this author

  • Conflict of interest: Nothing to declare.

Correspondence to: Margareta af Sandeberg, Department of Pediatric Hematology and Oncology, Astrid Lindgrens Childrens Hospital, The Karolinska University Hospital, Stockholm 16176, Sweden.

E-mail: margareta.afsandeberg@karolinska.se

Abstract

Background

The present study aimed to investigate the relationship between school attendance and infection requiring antimicrobial treatment in children undergoing treatment for cancer.

Procedure

A national cohort of children aged 7–16 years undergoing cancer treatment was assessed during two observation periods of 19 days each, 1 month (n = 89) and 2.5 months (n = 89) poststart of treatment. Children free from infection at start of each observation period were included. Multivariable logistic regression analyses were performed including factors potentially associated with start of antimicrobial treatment.

Results

Twenty-seven (30%) children started antimicrobial treatment during the first observation period. Factors associated with an increased risk of starting antimicrobial treatment were diagnosed with sarcoma (OR = 24.37, P = 0.002) or non-Hodgkin lymphoma (OR = 17.57, P = 0.025), having neutropenia (OR = 5.92, P = 0.020) and age less than 13 years (OR = 8.54, P = 0.014). During the second observation period, when 20 (22%) children started antimicrobial treatment, the probability of starting treatment was increased in children with neutropenia (OR = 4.25, P = 0.007). There was no statistically significant association between starting treatment for infection and school attendance.

Conclusions

In this study, children attending school while undergoing cancer treatment did not run a higher risk of starting antimicrobial treatment than children absent from school. However, there is a need for further studies evaluating risk of infections in children with ongoing cancer treatment. Pediatr Blood Cancer 2013;601307-1312. © 2013 Wiley Periodicals, Inc.

Ancillary