Abstract 894 Poster Session I, Saturday, 5/1 (poster 277)

A recent large multicenter study estimates Helicobacter pylori (H. pylori) seropositivity in healthy children to be approximately 15%, with a 22% prevalence in children with abdominal pain (Chong et. al, 1998). Children with cancer often complain of abdominal pain and are at high risk for infection. Yet, few studies have determined H. pylori seroprevalence in children with cancer, and none have looked at abdominal pain as a risk factor. Aim: To investigate whether abdominal pain is a risk factor for H. pylori seropositivity in children with cancer. Methods: We tested for H. pylori seropositivity in 30 children with cancer, who were also asked to rate their abdominal pain on a 5-point scale (1=none at all, 5=extremely severe). Parents were asked to help children rate their pain. Results were analyzed with simple t-tests for continuous variables, and Chi-squares for discrete variables. Results: 12 girls and 18 boys with cancer, with mean age of 8.2 (range 2-16.5) years old, were enrolled in the study. 30% of children (9/30) tested positive for H. pylori IgG antibody. Primary diagnoses were ALL (n=11), AML (2), and solid tumors (14). Seroprevalence rates did not differ by age or by primary diagnosis. 4 children who were H. pylori positive and 5 who were H. pylori negative had received a blood transfusion within 90 days of testing. 37% of children (n=11/30) reported some abdominal pain, with a mean pain score of 2.1. The presence of abdominal pain was not significantly associated with H. pylori seropositivity (p=0.8) (Table).

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Conclusions: This pilot study suggests that seropositivity for H. pylori infection in children with cancer may be greater than rates in healthy children. However, abdominal pain may not adequately predict risk for H. pylori seropositivity in this special population. Children with cancer are at high risk for all infections including H. pylori, which should be considered even in the absence of clinical symptoms.

The FlexSure HP kits were provided by SmithKline Diagnostics, Palo Alto, CA.