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What If My Child with Pediatric ALL Gets COVID-19?

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Published on August 25, 2020

What if My Child with Leukemia Gets Coronavirus?

If my child has pediatric acute leukemia are they at higher risk of getting coronavirus and having complications? What precautions should my child take? Pediatric ALL expert Dr. Alison Grimes from UT Health Sciences San Antonio discusses these questions with host Andrew Schorr. They are also joined by Kristin and Garrett Leihsing, the parents of a pediatric acute lymphoblastic leukemia patient, who share advice to fellow parents going through this. Watch to hear the full discussion.

This is part five of a five-part series, which includes:

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Transcript | What If My Child with Pediatric ALL Gets COVID-19?

Andrew Schorr:
Dr. Grimes, as we're doing this program, we have this COVID-19 pandemic going on. Okay. So the first question is, is a child diagnosed with acute leukemia more at risk? Because we've heard of some kids obviously who've had pediatric issues, sometimes different from adults, related to COVID, so we really don't know. So the first is the risk. And then going forward, Jaden goes out in the world, what about precautions? Is there anything extraordinary? So, first in the immediate and then maybe afterwards if you could talk about that.

Dr. Grimes:
Yeah. So in terms of contracting COVID, the risk is related to exposure. Regardless of whether you are a leukemia patient, or you have no cancer, no other health conditions. Children with leukemia aren't necessarily at higher risk of developing COVID-19 if they're following all of the precautions and trying to limit exposure as much as possible, which usually these families, it's like secondhand. They are already doing all those things. They know how to quarantine, they know how to wear a mask. So these kids are, they more like the model citizens, they know how to do these things and how to limit their exposures because they've been doing it anyway.

Where the risk comes into play for these kids though is the complications with the disease. We don't want any kid with leukemia to get COVID-19. Because depending on where their immune system is at that point in time, which is dependent on a lot of things, their disease process, the chemo that they've just received, what their counts look like, and so many other factors. The other conditions that they have. These kids are at risk for greater complications with COVID-19.

That being said, we have also seen, because we have global reports and nationally, within the Children's Oncology Group, we're actually tracking all of the cases of COVID-19 in all pediatric cancer patients, including not only the number of cases but the complications and the outcome. So even though these kids are considered to be at higher risk for complications, the vast majority of children with childhood ALL that are contracting COVID have minimal symptoms just like their age-matched peers that are contracting COVID and recovering. That won't be the case for every kid, so we think that extreme precaution is not only appropriate, it's very necessary. I don't want one kid to be the one that has a more severe outcome or a fatal result with COVID-19.

But it is good to see that many children with leukemia that are developing or contracting the virus are actually recovering just like other children are.

The precautions for Jaden really are similar to the precautions that he's had over the last two years of his therapy. But really targeted to COVID. His precautions are really to avoid crowds, he really shouldn't be joining in any kind of group gatherings. We would love to have end-of-therapy parties, and all of these things and he absolutely should have a celebration. But it shouldn't include a lot of people. It should include the contacts he's already had. So Jaden, their core family unit is the parents, the sibling, and the immediate grandparents, because they live right there, and he has had ongoing contact with them. The risk is when you expand that bubble.

So, for now, limiting expansion of that bubble is really our goal because of COVID. If it weren't because of COVID, as we're reaching the end of therapy, we definitely would have looser restrictions with many of those things. And already previously, during maintenance therapy, had looser restrictions with many of those instructions. So that is more restricted because of COVID, but he can play outside, he can play in the water, there are other things he can certainly do to keep him active, to introduce some activity and joy in his life. As he's completing therapy, that won't increase his risk of a COVID exposure.

Andrew Schorr:
It sounds like as you've taken us through both Jaden's story and what is standard therapy, and immunotherapy developing, and therapy should the ALL relapse. It's a very hopeful story, now, I think that parents need to hear. What would you say?

Dr. Grimes:
Absolutely. Of all the childhood cancers, pre B ALL, the type of cancer that Jaden has, is associated with one of the highest cure rates of the childhood cancers. We don't want any kid to have cancer. And I actually hope that in my lifetime, I'm out of a job. And with the innovations that are in place now, maybe that will happen. I'm actually hopeful that it will. But the story for childhood leukemias has moved from one of severe despair, several decades ago, to hope, to cure for the vast majority of families. And for those that don't have cure upfront, many options for refractory disease. It is a hopeful story.

Andrew Schorr:
Well, Dr. Allison Grimes, thank you for being with us from UT in San Antonio there and your devotion. You and your team, you are our angels. Right?

Kristin Leihsing:
Absolutely.

Andrew Schorr:
And you truly are, right? Kristin, right?

Garrett Leihsing:
Yeah.

Kristin Leihsing:
Yes.

Andrew Schorr:
They are our angels. So, Dr. Allison Grimes, thank you for being with us. So, Kristin and Garrett, you've been living with it. And now hopefully you're at the end of the marathon forever. Okay. What do you want to say to other parents? What do you want to say?

Kristin Leihsing:
Keep thinking positive. Try to create your new norm and continue to live life. It shouldn't be a life stopper, it makes you realize a little bit more of what's important, and you just get creative with things that you can do in your home. But staying as positive as you possibly can.

Andrew Schorr:
Okay. Well, a lot of credit to you as a parent for what you've been through. And hopefully, you have a great life. Garrett, any final comment you want to say to the dads, for example?

Garrett Leihsing:
Definitely be more in tune, and more on top of your emotions rather than just head down, trying to plow through it. Look at the big picture of things rather than focusing on small things. And at the end of the day, you'll get through it, it'll be a rough couple of years. But you'll come out ahead.

Andrew Schorr:
Thank you so much for being with us, the Leihsings from Bulverde, Texas. And all the best to you, and Emma, and Jaden. Thanks for being with us.

This is what we do at Patient Power. And really I hope it gives you, dealing with ALL, a great deal of confidence that there are a range of treatments now and very devoted providers, and other families that have been through it, like the Leihsings, to give you community and hope. Thank you so much for being with us in Northern California with my friends in Texas. I'm Andrew Schorr. Remember, knowledge can be the best medicine of all.


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