Low prevalence of complications in severe neutropenic children with cancer in the unprotected environment of an overnight camp

Abstract

The high risk of infection and other complications in severely neutropenic pediatric oncology patients receiving chemotherapy has led to development of a variety of preventive measures including isolation and diet restrictions. In order to examine the potential impact of these measures, we evaluated the outcomes of such patients attending a recreational summer camp. We collected data on all children who attended an overnight summer camp for children with cancer during the years 1999-2004, and who were either severely neutropenic or at a high-intensity phase of chemotherapy. Outcome measures included fever, bleeding, hospitalization, and clinical or laboratory evidence of infection. The observation period included both, the 2-week camp experience and 30 days post-camp. The study group was comprised of 34 patients. Although nine (24%) were hospitalized for management of fever and neutropenia, only one patient had clinical or culture-positive evidence of an invasive infectious agent. No bleeding episode was recorded and most patients attended all camp activities. Our results support the safety and feasibility of severely neutropenic patients with cancer to attend the non-isolated, non-sterile environment of a summer camp. These findings may be applicable to school and other social settings.