Minimizing infection risk key to survivors’ health

Risks for an infection are increased in adult survivors of childhood cancer. Proper immunizations and care can lower the possibility.

Published: 8/1/14


Adult survivors of childhood cancer face an increased risk of infections years after therapy. Fortunately, survivors’ overall risk of death from infection is low.  However, some personal and treatment-related characteristics increase the risk of infections and complications from infections.

Almost a third of the survivors in a recent LTFU study analysis reported having a serious infection (such as pneumonia, sinusitis, bladder infection, hepatitis, etc.) more than 5 years after diagnosis of childhood cancer. Survivors of Hodgkin and non-Hodgkin lymphoma had the highest overall risk. Survivors who smoked, either currently or in the past, had increased rates of sinus and lung infections.

In addition, although the overall risk was low, this study found that survivors, especially those who received total body irradiation, were several times more likely to die from infections compared to the US population. The number of deaths reported was very low. A total of 65 deaths (0.5 percent) were reported among more than 12,000 survivors included in this study.

The study investigators stress that survivors and their healthcare providers must be aware of the need for appropriate immunizations and prompt care for suspected infections.

To minimize your risk:

Check with your healthcare provider right away if you have any signs of infection.  Signs of infection include: fever, unusual tiredness, muscle aches, chills, headache, vomiting, diarrhea, and/or abdominal pain. If you are having symptoms that you are not sure are related to an infection, contact your provider for recommendations.

Go over your immunization record with your healthcare provider and make sure you are up-to-date with all vaccinations and booster doses.

Make sure all your healthcare providers know the details of your cancer treatment. If you had your spleen removed or had total body radiation or abdominal radiation, some providers may recommend that you take daily preventive antibiotics.

Ask your healthcare provider if preventive antibiotics are needed before any dental work is done.

The Children’s Oncology Group publishes long-term follow-up care guidelines for survivors of childhood cancer. The guidelines are available at Please share this important resource with all your healthcare providers.


Infections among long-term survivors of childhood and adolescent cancer: a report from the Childhood Cancer Survivor Study. Perkins JL, Chen Y, Harris A, Diller L, Stovall M, Armstrong GT, Yasui Y, Robison LL, Sklar CA. Cancer. 2014 Aug 15;120(16):2514-21.