Pediatric hematologist and oncologist, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
The World Health Organization (WHO) has announced that COVID -19 is a public health emergency requiring international concern. Children patients with cancer are highly vulnerable to this virus during SARS-CoV- 2 outbreak. These children have varying degree of immunosuppression due to primary illness and also anti-tumor therapy. Although children in comparison to adults have a milder course of COVID -19 infection, pediatric patients with malignancies had a higher risk for severe clinical events due to COVID -19 in comparison to children without cancer. Most neoplasms in pediatric population have an aggressive manner and therefore require prolonged periods of multi agent chemotherapy. In adults with cancer who have stable disease, postponement of therapy could be possible, but in children delay in onset of treatment is not a suitable option. One of the most effective strategies in order to prevent COVID -19 is minimizing the risk of exposure and also extreme isolation. Moreover, in majority of children with cancer hospital admission is required. At now there is no specific antiviral treatment for SARS -CoV - 2, hence the increased surveillance and preventive strategies in order to reduce the risk of exposure should be considered. There are many unanswered questions in management of children with cancer who were infected with COVID -19. In this setting, treatment decisions need to be individualized on a case-by-case basis and in order to deliver a suitable treatment, patient stratification is required. Pediatric patients with cancer should receive their anti-cancer treatment in the setting of vigorous screening for SARS -CoV - 2. Further studies are needed to understand the course of COVID -19 infection in children with cancer.