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| LETTER TO EDITOR |
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| Year : 2021 | Volume
: 4
| Issue : 3 | Page : 592 |
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Authors' reply to Thacker and Desai et al.
Swati Bhayana, Manas Kalra, Pallavi Sachdeva, Anupam Sachdeva
Department of Pediatric Hematology Oncology and BMT Unit, Institute of Child Health, Sir Ganga Ram Hospital, New Delhi, India
| Date of Submission | 08-Sep-2021 |
| Date of Decision | 08-Sep-2021 |
| Date of Acceptance | 10-Sep-2021 |
| Date of Web Publication | 08-Oct-2021 |
Correspondence Address:
Anupam Sachdeva
Department of Paediatric Hematology Oncology and BMT Unit, Institute of Child Health, Sir Ganga Ram Hospital, New Delhi
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/crst.crst_220_21
How to cite this article:
Bhayana S, Kalra M, Sachdeva P, Sachdeva A. Authors' reply to Thacker and Desai et al. Cancer Res Stat Treat 2021;4:592 |
We thank Thacker[1] and Desai et al.[2] for their interest in our study and comments on our recently published article.[3] As highlighted by the authors, the impact of chemotherapy modification on the long-term outcomes in children with cancer is a matter of concern. So far, none of our patients whose treatment was interrupted have suffered from an early relapse. Long-term follow-up is needed to compare their baseline risk factors and outcomes with children whose treatment was not interrupted or those who did not develop COVID-19 infection.
Dr. Thacker is correct in highlighting that we excluded patients who did not have COVID-19 positivity either on reverse transcription-polymerase chain reaction (RT-PCR) or antigen or BioFire testing. We also excluded antibody positive cases with no evidence of multisystem inflammatory syndrome in children (MIS-C). We did include one patient who presented with a severe form of MIS-C, shock, and tuberculosis to highlight the newer potential challenges that we may face in future.
The author is correct in highlighting the frequent repeat testing done in our patients. The knowledge regarding COVID-19 infectivity, the time for the RT-PCR test result to become negative, and the persistence of viral RNA in respiratory samples evolved as the pandemic progressed. We stopped doing repeat testing for our patients in October 2020. During the second wave of the pandemic, we did not retest patients to document COVID-19 negativity. However, in view of the emergence of new variants/mutants that created havoc in the second wave, we continue to test all children with cancer on active treatment for COVID-19 infection, once in 2–3 weeks as per the hospital policy. This includes children who have suffered from COVID-19 infection in the past.
We appreciate Dr. Thacker's comment on vaccination. Recent published literature shows that high-risk children with hematological malignancies have been significantly impacted and have had poor outcomes during the second wave of the pandemic.[4] We would therefore like to appeal to the vaccine companies and researchers to test the safety and efficacy of the COVID-19 vaccination in this high-risk population. This will indeed prevent morbidity, mortality, and treatment delays.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | |  |
| 1. | Thacker D. Low burden of COVID-19 disease in children with cancer and hematologic illnesses. Cancer Res Stat Treat 2021;4:590-1.  [Full text] |
| 2. | Desai N, Gupta A, Mehta P. COVID-19 in children with hematological disorders – Outcomes, impact on management and the way forward. Cancer Res Stat Treat 2021;4:589-90. [Full text] |
| 3. | Bhayana S, Kalra M, Sachdeva P, Sachdeva A. Clinical profile and outcomes of COVID-19 infection during the first wave in children with hematological illnesses and cancer: An observational study from a tertiary care center in North India. Cancer Res Stat Treat 2021;4:262-9. [Full text] |
| 4. | Mukkada S, Bhakta N, Chantada GL, Chen Y, Vedaraju Y, Faughnan L, et al. Global characteristics and outcomes of SARS-CoV-2 infection in children and adolescents with cancer (GRCCC): A cohort study. Lancet Oncol 2021:S1470-2045(21)00454-X. Epub ahead of print. |
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