By Emma Wilkinson
Health reporter, BBC News
Chemotherapy can leave children vulnerable to infection
More needs to be done to prevent children with cancer dying from infection, researchers say.
Analysis of death certificates in England and Wales over a two-year period found infection was the cause of death in 82 child cancer patients.
Such deaths could well be preventable if better strategies were in place to avoid, diagnose and treat infections, the UK researchers said.
The findings appear in the journal Pediatric Blood and Cancer.
Treatment of child cancer has improved drastically in the past few decades and so have survival rates.
But increasingly aggressive chemotherapy means patients are vulnerable to other illnesses.
The study of children under 15 with cancer who died between 2003 and 2005 found that in 25% of blood cancers, such as leukaemia the cause of death was infection rather than the cancer itself.
In children with solid tumours the figure was 5%.
Children with blood cancers are more susceptible to infection because the disease itself can affect the production of white blood cells, a key part of the immune system, and harsh treatments can make them even more vulnerable.
The researchers said the figures in the study were likely to be an underestimate of the numbers dying due to infection because of the limits of the data they had available to them.
Study leader Dr Jessica Bate, a clinical lecturer in child health at St George's University of London, said better treatments meant children were far more likely to survive cancer than previously but at the same time the nature of the treatment meant the immune system was weakened to a greater extent.
"Survival rates are so much better than they have been, most children are surviving now and that's great but what we don't want is that they die from infections because that's something we should be able to do something about."
She added: "Some of the infections we found we should be able to treat - we have good antibiotics and we have good protocols - so it does raise the question why this small group of children is succumbing to that."
"The thing we need to think about the future is whether we diagnose them properly.
"And the big thing that came out was fungal infections and that's an area where we really need to improve how we diagnose them and how we treat them."
Liz Baker, senior science information officer at Cancer Research UK, said: "Incredible progress has been made in treating children's cancer more effectively.
"Sadly, these treatments can sometimes weaken the immune system.
"Targeted therapies with fewer side effects on the immune system and preventative strategies in hospitals will help to reduce this problem."