Infection-Related Mortality in Children With Cancer: A 21-Year Single-Center Retrospective Observational Study

Background:Infection-related mortality (IRM) is the most common type of treatment-related mortality (TRM), representing ~ 70% of TRM among patients with hematologic malignancies.It explains ~ 30% of deaths in patients with acute leukemia and comprises up to 75% of TRM in patients with lymphoma.This study explored features of microbiologically confirmed infection-related deaths over 21 years among pediatric oncology patients at a tertiary referral center. Material/Methods:We retrospectively reviewed the medical records of pediatric oncology patients who died during hospitalization at the University Children's Hospital in Lublin between January 1, 2004, and December 31, 2024.The mortality cohort comprised 70 deceased patients.Of these, 52 had a documented infection during anticancer treatment; 17 deaths fulfilled predefined criteria for microbiologically confirmed IRM.Analyses were primarily descriptive. Results:During the study period, 70 in-hospital deaths were recorded.Infections during treatment occurred in 52 patients, and IRM contributed to 17 deaths (24.3%).IRM was the most common cause of TRM and second most common cause of death.Boys slightly predominated in the IRM group.The median age of patients with IRM was 85 months; the median time from cancer diagnosis to death was 12 months.Exploratory subgroup analyses indicated lower baseline leukocyte, neutrophil, and lymphocyte counts in the fungal IRM subgroup.Higher C-reactive protein concentrations during the fatal infectious episode were observed in the bacterial IRM subgroup. Conclusions:In this single-center mortality cohort, microbiologically confirmed IRM contributed to approximately one-quarter of in-hospital deaths and represented the predominant component of TRM.Bacterial infections were the most frequently documented cause of IRM.