Table II.
Characteristics of 20 children with acute lymphoblastic leukemia who died of varicella infection
| Patient | Age at death (y) | Varicella vaccination | ALL protocol | Treatment phase | ALL status at time of death | Time from diagnosis of ALL to diagnosis of varicella | Days from varicella onset to death | Cause of death |
|---|---|---|---|---|---|---|---|---|
| 1 | 9 | No | JACLS-97 | Induction | AD | 27 days | 13 | Multiple organ failure |
| 2 | 18 | No | INS-89 | 6 months off therapy | CR | 2.5 years | 6 | Massive hepatic failure and acute respiratory insufficiency |
| 3 | 5 | No | INS 2003 | Induction | AD | 10 days | 5 | Pneumonia, hepatitis, disseminated intravascular coagulation, multiple organ failure. |
| 4 | 4 | No | INS 2003 | Maintenance | CR | 18 months | 33 | Acute myocarditis |
| 5 | 13 | No | DCOG-9 | 20 weeks after transplantation | NK | NK | 15 | Pneumonia |
| 6 | 6 | No | DCOG-10 | Maintenance | CR | 18 months | 38 | Pneumonia |
| 7 | 6 | No | KYCCSG 02 | Re-induction | CR | 5 months | 2 | Disseminated intravascular coagulation |
| 8 | 4 | NK* | ALL-BFM 2000 | Prephase of induction | Before treatment | 2 days | 3 | Pneumonia, pulmonary leukostasis syndrome |
| 9 | 4 | Yes21 | ALL-BFM 2000 | Re-induction | CR | 5 months | 13 | Hepatitis, encephalitis, multiple organ failure.* |
| 10 | 3 | NK | ALL-BFM 2000 | Induction | AD | 45 days | 22 | Hepatitis, encephalitis |
| 11 | 5 | No | ALL-BFM 2000 | Maintenance | CR | 18 months | 6 | Pneumonitis, cardio-respiratory failure |
| 12 | 5 | No | ALL-BFM 2000 | Re-induction | CR | 6 months | 3 | Hepatitis |
| 13 | 5 | No | ALL-BFM 2000 | Induction | AD | 15 days | 13 | Hepatitis, encephalitis, multiple organ failure. |
| 14 | 4 | No | ALL-BFM 2000 | Re-induction | CR | 6 months | 9 | Hepatitis, pancreatitis, nephritis, encephalitis |
| 15 | 4 | No | AIEOP ALL2000 |
At diagnosis of leukemia | Before treatment | 0 days | 1 | Interstitial pneumonia |
| 16 | 16 | No | SJCRH Total XI |
Maintenance | CR | 7 months | 4 | Hepatitis, renal failure, pneumonia, DIC |
| 17 | 2 | No | AIEOP ALL91 |
Induction | AD | 26 days | 5 | Myocarditis, multiple organ failure |
| 18 | 6 | No | AIEOP ALL91 |
Consolidation | CR | 75 days | 4 | Multiple organ failure, encephalitis, meningitis |
| 19 | NK | NK | POG | NK | NK | 17 moths | NK | NK |
| 20 | NK | NK | POG | NK | NK | 17 moths | NK | NK |
NK: not known; CR: Complete remission; NA: not applicable; AD: active disease
*
Varicella vaccination was introduced in Germany in 2004/2005.