1
|
Kili A, ElKababri M, Coze C, Patte C, Van Heerden J, Martelli H, Harif M, Hessissen L. A Transformative Decade: An Evaluation of the Francophone African Group of Pediatric Oncology's Training Program (2014-2024). JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2024:10.1007/s13187-024-02499-6. [PMID: 39235549 DOI: 10.1007/s13187-024-02499-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/27/2024] [Indexed: 09/06/2024]
Abstract
Childhood cancer in Africa faces significant challenges due to workforce shortages and limited training opportunities. The French African Group for Pediatric Oncology (GFAOP) established the African School of Pediatric Oncology and introduced a pediatric oncology teaching called the "Diplome Universitaire de Cancérologie Pédiatrique" (DUCP) training program. This report evaluates the contributions of the DUCP program to pediatric oncology in Africa and discusses the sustainability of the program. The DUCP program trained six cohorts of healthcare professionals from French-speaking African countries since 2014. An evaluation was done on the participant demographics and regional contributions. Data were collected from trainee records and DUCP records. The DUCP program was evaluated based on the domains developed by the Education Program Assessment Tool (EPAT). Over the 10-year period, the DUCP program trained 107 healthcare professionals from 20 Francophone countries of which 99% were retained in Africa. Of the 83 graduates, 55 (66%) actively practice in pediatric oncology. Of the 18 francophone countries, 17 countries increased the number of pediatric oncologists and 16 improved the ratio of pediatric oncologists to children under 15 years. Nine new pediatric oncology services were established by the graduates thus far. Despite challenges, such as the COVID-19 pandemic, the program remains sustainable because of continued financial support, collaborations with the international pediatric oncology community, and adapting the program content to participant and local setting needs. Retention of graduates in childhood cancer services remains a challenge that necessitates governmental involvement. The DUCP program is impactful and sustainable and improves access for children to cancer services in Africa. By fostering continued collaboration with governments, addressing the needs of an increasing African population, and expanding support for similar initiatives, the program's longevity and positive impact can be further ensured.
Collapse
Affiliation(s)
- Amina Kili
- Pediatric Hematology and Oncology Department, University Mohammed V, Rabat, Morocco
| | - Maria ElKababri
- Pediatric Hematology and Oncology Department, University Mohammed V, Rabat, Morocco
| | - Carole Coze
- Aix Marseille University - Assistance Publique Des Hôpitaux de Marseille, Marseille, France
| | - Catherine Patte
- Francophone African Group of Pediatric Oncology, Villejuif, France
| | - Jaques Van Heerden
- Department of Paediatric Oncology, Antwerp University Hospital, Antwerp, Belgium
| | - Hélène Martelli
- Francophone African Group of Pediatric Oncology, Villejuif, France
| | - Mhamed Harif
- Francophone African Group of Pediatric Oncology, Villejuif, France
| | - Laila Hessissen
- Pediatric Hematology and Oncology Department, University Mohammed V, Rabat, Morocco.
- Francophone African Group of Pediatric Oncology, Villejuif, France.
| |
Collapse
|
2
|
Rigby KL, Diaz MJ, Gozlan EC, Kacsoh DB, Song JJ, Hudock TR, Chobrutskiy A, Chobrutskiy BI, Blanck G. Worse Wilms' Tumor Outcomes Associated With Chemical Complementarity for Multiple T-Cell Receptor CDR3-CMV Epitope Pairs. Cancer Genomics Proteomics 2024; 21:439-447. [PMID: 39191494 PMCID: PMC11363928 DOI: 10.21873/cgp.20462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 07/09/2024] [Accepted: 07/22/2024] [Indexed: 08/29/2024] Open
Abstract
BACKGROUND/AIM Wilms' tumors are pediatric renal tumors that generally have a good prognosis and outcomes. Viral illnesses have been linked to development of neoplasms and should be considered as a factor that could modulate overall survival. MATERIALS AND METHODS We considered recently developed adaptive immune receptor, genomics and bioinformatics approaches to assess the potential impact of cytomegalovirus (CMV) infections in Wilms' tumor. RESULTS T-cell receptor (TCR) complementarity determining region-3 (CDR3) amino acid sequences from Wilms' tumor specimens represented by the Therapeutically Applicable Research to Generate Effective Treatments dataset were compared with known anti-CMV TCR CDR3s, indicating that cases representing the anti-CMV TCR CDR3s had worse outcomes. Then, a chemical complementarity scoring approach for the Wilms' tumor, TCR CDR3s and a series of CMV antigens further indicated that cases representing a higher chemical complementarity to the CMV antigens had worse outcomes. CONCLUSION Overall, we present a potentially novel method to assess CMV infections and identify patients who could benefit from therapies that address such infections.
Collapse
Affiliation(s)
- Kasey L Rigby
- University of Central Florida College of Medicine, Orlando, FL, U.S.A
| | - Michael J Diaz
- Department of Molecular Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL, U.S.A
| | - Etienne C Gozlan
- Department of Molecular Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL, U.S.A
| | - Dorottya B Kacsoh
- University of Central Florida College of Medicine, Orlando, FL, U.S.A
| | - Joanna J Song
- Department of Molecular Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL, U.S.A
| | - Tabitha R Hudock
- Department of Molecular Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL, U.S.A
| | - Andrea Chobrutskiy
- Department of Pediatrics, Oregon Health and Science University Hospital, Portland, OR, U.S.A
| | - Boris I Chobrutskiy
- Department of Internal Medicine, Oregon Health and Science University Hospital, Portland, OR, U.S.A
| | - George Blanck
- Department of Molecular Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL, U.S.A.;
- Department of Immunology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, U.S.A
| |
Collapse
|
3
|
Ong FRC, Yu HVT, Alcasabas APA, Cañeba JPD, Estanislao JI, Fajardo PD. Profile and Outcomes of Pediatric Hematology and Oncology Patients Diagnosed with COVID-19 in the Philippine General Hospital. ACTA MEDICA PHILIPPINA 2024; 58:163-169. [PMID: 38882910 PMCID: PMC11168950 DOI: 10.47895/amp.v58i7.6865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
Introduction The coronavirus pandemic has affected millions worldwide. Better understanding of COVID-19 in pediatric hematology-oncology patients in a resource-limited setting is crucial to improve care as the pandemic ensues. Objectives This study describes the clinical profile and outcomes of pediatric hematology oncology patients with COVID-19 seen at the Philippine General Hospital (PGH). Methods A retrospective, descriptive review of pediatric hematology oncology patients with COVID-19 seen between March 2020 to March 2021 in PGH was done. Results Forty patients were identified. Seventeen percent had non-malignant hematologic conditions, 40% had leukemias, and 42.5% had solid tumors. Fever and cough were the most common manifestations. Seventy-six percent were on treatment, 9% were newly diagnosed, and 7% were in relapse or disease progression. Fifty-five percent had mild COVID-19; 5% and 2.5% had severe and critical COVID-19, respectively. Thirty-seven percent were asymptomatic. Cancer-related therapy was placed on hold for most patients. There were two mortalities, none was due to COVID-19. Conclusion Results suggest that patients with hematologic and oncologic conditions have a mild course, with majority showing recovery from COVID-19. Delays in cancer-related therapy however, may contribute to disease progression and mortality.
Collapse
Affiliation(s)
- Faustine Richelle C Ong
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Philippine General Hospital, University of the Philippines Manila
| | - Hazel Valerie T Yu
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Philippine General Hospital, University of the Philippines Manila
| | - Ana Patricia A Alcasabas
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Philippine General Hospital, University of the Philippines Manila
| | - Joliza Patricia D Cañeba
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Philippine General Hospital, University of the Philippines Manila
| | - Jochrys I Estanislao
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Philippine General Hospital, University of the Philippines Manila
| | - Pamela D Fajardo
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Philippine General Hospital, University of the Philippines Manila
| |
Collapse
|
4
|
Zama D, Zanaroli A, Corbelli A, Lo Vecchio A, Del Bene M, Colombini A, Compagno F, Barone A, Fontanili I, Rosaria D'Amico M, Papa MR, Petris MG, Calore E, Montalto S, Meneghello L, Brescia L, Mura R, La Spina M, Muggeo P, Rinieri S, Meazza C, Perruccio K, Cellini M, Spadea M, Mercolini F, Petroni V, De Santis R, Soncini E, Provenzi M, Giurici N, Ziino O, Tridello G, Cesaro S. SARS-CoV-2 Infection in the Pediatric Oncology Population: The Definitive Comprehensive Report of the Infectious Diseases Working Group of AIEOP. J Infect Dis 2024; 229:1050-1058. [PMID: 37962869 DOI: 10.1093/infdis/jiad496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 09/20/2023] [Accepted: 11/11/2023] [Indexed: 11/15/2023] Open
Abstract
OBJECTIVE The objective of this study was to assess the clinical impact and outcome of the SARS-CoV-2 infection on children with cancer or those who received a hematopoietic stem cell transplantation. METHODS AIEOP (Italian Association of Pediatric Hematology and Oncology) performed a nationwide multicenter observational cohort study, including consecutive patients between April 2020 and November 2022. RESULTS Twenty-five Italian centers participated and 455 patients were enrolled. We reported a significant increasing trend of symptomatic cases over the years, while the number of nonmild infections remained stable. Early infection after oncologic diagnosis (<60 days) and severe neutropenia were identified as independent risk factors for developing moderate, severe, or critical infections. The percentage of patients who were asymptomatic and mildly symptomatic and who stopped chemotherapy reduced over the years of the pandemic. Nine patients died, but no death was attributed to SARS-CoV-2 infection. CONCLUSIONS SARS-CoV-2 infection presented a self-limiting benign course in the Italian pediatric oncohematology population during the pandemic, and its main consequence has been the discontinuation of cancer-directed therapies. The rate of patients who were asymptomatic and stopped chemotherapy reduced over the years, suggesting that the continuation of chemotherapy is a feasible option.
Collapse
Affiliation(s)
- Daniele Zama
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna
| | - Andrea Zanaroli
- Pediatric Oncology and Hematology Department, Istituto di Ricovero e Cura a Carattere Scientifico, Azienda Ospedaliero-Universitaria di Bologna
| | - Agnese Corbelli
- Pediatric Hematology and Oncology, Department of Mother and Child, Azienda Ospedaliera Universitaria Integrata, Verona
| | - Andrea Lo Vecchio
- Department of Translational Medical Sciences, Section of Pediatrics, University of Naples Federico II, Naples
| | - Margherita Del Bene
- Department of Translational Medical Sciences, Section of Pediatrics, University of Naples Federico II, Naples
| | - Antonella Colombini
- Antonella Colombini, Fondazione IRCCS, Ospedale San Gerardo dei Tintori, Monza
| | - Francesca Compagno
- Pediatric Hematology/Oncology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia
| | - Angelica Barone
- Pediatric Onco-hematology Unit, Ospedale dei Bambini, Azienda Ospedaliero-Universitaria di Parma
| | - Ilaria Fontanili
- Pediatric Onco-hematology Unit, Ospedale dei Bambini, Azienda Ospedaliero-Universitaria di Parma
| | | | | | - Maria Grazia Petris
- Women's and Children's Health, Clinic of Pediatric Hemato-oncology, University of Padua
| | - Elisabetta Calore
- Pediatric Hematology, Oncology and Stem Cell Transplant Division, Department of Women's and Children's Health
- European Reference Network for Paediatric Transplantation Member for Hematopoietic Stem Cell Transplantation, University Hospital of Padova
| | - Shana Montalto
- Pediatric Infectious Diseases Unit, IRCCS Istituto Giannina Gaslini, Genoa
| | | | | | - Rosamaria Mura
- Pediatric Oncology Unit, Azienda Ospedaliera Brotzu, Cagliari
| | - Milena La Spina
- Pediatric Hematology and Oncology Unit, AOU Policlinico "Rodolico-San Marco," University of Catania
| | - Paola Muggeo
- Pediatric Oncology-Hematology Unit, Department of Pediatrics, Azienda Ospedaliero Universitaria Policlinico, Bari
| | - Simona Rinieri
- Pediatric Unit, Onco-hematology Day Hospital, Sant'Anna Hospital, Ferrara
| | - Cristina Meazza
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano
| | - Katia Perruccio
- Pediatric Oncology-Hematology, Santa Maria della Misericordia Hospital, Perugia
| | - Monica Cellini
- Pediatric Oncology-Hematology Unit, Department of Mother and Child, Azienda Ospedaliero Universitaria Modena
| | - Manuela Spadea
- Department of Public Health and Pediatrics, University of Turin
- Pediatric Onco-hematology, Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children's Hospital, Turin
| | - Federico Mercolini
- Pediatric Oncology and Hematology Department, Istituto di Ricovero e Cura a Carattere Scientifico, Azienda Ospedaliero-Universitaria di Bologna
- Pediatric Onco-hematology Unit, Department of Pediatrics, Hospital of Bolzano
| | - Valeria Petroni
- Division of Pediatric Hematology and Oncology, Ospedale G Salesi, Ancona
| | - Raffaella De Santis
- Hemato-oncology Unit, Department of Pediatrics, "Casa Sollievo Della Sofferenza" Hospital, San Giovanni Rotondo
| | - Elena Soncini
- Pediatric Oncohematology and Bone Marrow Transplant Unit, Children's Hospital, Spedali Civili, Brescia
| | | | - Nagua Giurici
- Pediatric Hematology-Oncology, Institute for Maternal and Child Health IRCCS "Burlo Garofolo,"Trieste
| | - Ottavio Ziino
- Department of Pediatric Hemato-oncology, ARNAS Ospedali Civico, G Di Cristina, Palermo, Italy
| | - Gloria Tridello
- Pediatric Hematology and Oncology, Department of Mother and Child, Azienda Ospedaliera Universitaria Integrata, Verona
| | - Simone Cesaro
- Pediatric Hematology and Oncology, Department of Mother and Child, Azienda Ospedaliera Universitaria Integrata, Verona
| |
Collapse
|
5
|
Jiang C, Yang Y, Yang W, Ma X, Chu P, Duan C, Wang X, Jian B, Zhao W, He S, Wang X, Zhang S, Zhao Q, Yang P, Huang C, Ma G, Su Y, Guo Y. Impact of the COVID-19 pandemic on the demographic and disease burden of pediatric malignant solid tumors in China: a single-center, cross-sectional study. Transl Pediatr 2024; 13:387-398. [PMID: 38590381 PMCID: PMC10998988 DOI: 10.21037/tp-23-480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 01/06/2024] [Indexed: 04/10/2024] Open
Abstract
Background With the development of the novel coronavirus disease 2019 (COVID-19), China implemented measures in an attempt to control the infection rate. We conducted a single-center, cross-sectional study to ascertain the impact of the COVID-19 pandemic on the equitable availability of medical resources for children diagnosed with malignant solid tumors in China. Methods Data on the demographics, clinical characteristics, and medical expenses of 876 patients diagnosed with neuroblastoma, rhabdomyosarcoma (RMS), Wilms tumor, hepatoblastoma (HB), Ewing sarcoma (ES), and central nervous system (CNS) tumors from 2019 to 2021, during the COVID-19 pandemic, were retrospectively collected from the National Center for Children's Health. The Pearson χ2 test and Mann-Whitney test were performed to analyze the differences among variables. Results Except for the regional origin of children with tumors during the epidemic, no significant differences were found in the demographic or clinical characteristics of patients at initial diagnosis. The number of patients from northern China and northeastern China who attended Beijing Children's Hospital (BCH) increased after the outbreak of COVID-19 (P=0.001). There was no significant alteration observed in the frequency of hospitalizations per individual per annum (P=0.641) or the mean expense incurred per individual per hospitalization (P=0.361). In addition, the medical insurance coverage rate of real-time settlement increased year by year. Conclusions After the COVID-19 outbreak, the origin of patients with solid tumor who visited BCH was concentrated in the northern region of China. COVID-19 had no impact on the other demographic factors, clinical characteristics, or economic burden of patients with pediatric malignant solid tumors.
Collapse
Affiliation(s)
- Chiyi Jiang
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, MOE Key Laboratory of Major Diseases in Children, Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
- Medical Oncology Department, Pediatric Oncology Center, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Clinical Discipline of Pediatric Oncology, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing, China
| | - Yeran Yang
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, MOE Key Laboratory of Major Diseases in Children, Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
| | - Wenfa Yang
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, MOE Key Laboratory of Major Diseases in Children, Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
| | - Xiaoli Ma
- Medical Oncology Department, Pediatric Oncology Center, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Clinical Discipline of Pediatric Oncology, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing, China
| | - Ping Chu
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, MOE Key Laboratory of Major Diseases in Children, Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
| | - Chao Duan
- Medical Oncology Department, Pediatric Oncology Center, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Clinical Discipline of Pediatric Oncology, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing, China
| | - Xinyu Wang
- Big Data Center, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
| | - Binglin Jian
- Medical Oncology Department, Pediatric Oncology Center, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Clinical Discipline of Pediatric Oncology, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing, China
| | - Wen Zhao
- Medical Oncology Department, Pediatric Oncology Center, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Clinical Discipline of Pediatric Oncology, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing, China
| | - Sidou He
- Medical Oncology Department, Pediatric Oncology Center, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Clinical Discipline of Pediatric Oncology, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing, China
| | - Xisi Wang
- Medical Oncology Department, Pediatric Oncology Center, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Clinical Discipline of Pediatric Oncology, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing, China
| | - Shihan Zhang
- Medical Oncology Department, Pediatric Oncology Center, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Clinical Discipline of Pediatric Oncology, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing, China
| | - Qian Zhao
- Medical Oncology Department, Pediatric Oncology Center, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Clinical Discipline of Pediatric Oncology, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing, China
| | - Peiyi Yang
- Medical Oncology Department, Pediatric Oncology Center, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Clinical Discipline of Pediatric Oncology, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing, China
| | - Cheng Huang
- Medical Oncology Department, Pediatric Oncology Center, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Clinical Discipline of Pediatric Oncology, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing, China
| | - Geng Ma
- Futang Research Center of Pediatric Development (FRCPD), Beijing, China
| | - Yan Su
- Medical Oncology Department, Pediatric Oncology Center, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Clinical Discipline of Pediatric Oncology, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing, China
| | - Yongli Guo
- Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, MOE Key Laboratory of Major Diseases in Children, Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
| |
Collapse
|
6
|
Kiwumulo HF, Muwonge H, Ibingira C, Lubwama M, Kirabira JB, Ssekitoleko RT. A di-electrophoretic simulation procedure of iron-oxide micro-particle drug attachment system for leukemia treatment using COMSOL software: a potential treatment reference for LMICs. FRONTIERS IN MEDICAL TECHNOLOGY 2023; 5:1250964. [PMID: 37901748 PMCID: PMC10602814 DOI: 10.3389/fmedt.2023.1250964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 09/29/2023] [Indexed: 10/31/2023] Open
Abstract
Background Leukemia encompasses various subtypes, each with unique characteristics and treatment approaches. The challenge lies in developing targeted therapies that can effectively address the specific genetic mutations or abnormalities associated with each subtype. Some leukemia cases may become resistant to existing treatments over time making them less susceptible to chemotherapy or other standard therapies. Objective Developing new treatment strategies to overcome resistance is an ongoing challenge particularly in Low and Middle Income Countries (LMICs). Computational studies using COMSOL software could provide an economical, fast and resourceful approach to the treatment of complicated cancers like leukemia. Methods Using COMSOL Multiphysics software, a continuous flow microfluidic device capable of delivering anti-leukemia drugs to early-stage leukemia cells has been computationally modeled using dielectrophoresis (DEP). Results The cell size difference enabled the micro-particle drug attachment to the leukemia cells using hydrodynamic focusing from the dielectrophoretic force. This point of care application produced a low voltage from numerically calculated electrical field and flow speed simulations. Conclusion Therefore, such a dielectrophoretic low voltage application model can be used as a computational treatment reference for early-stage leukemia cells with an approximate size of 5 μm.
Collapse
Affiliation(s)
- Henry Fenekansi Kiwumulo
- Department of Medical Physiology, Biomedical Engineering Program, Makerere University, Kampala, Uganda
| | - Haruna Muwonge
- Department of Medical Physiology, Biomedical Engineering Program, Makerere University, Kampala, Uganda
- Habib Medical School, Islamic University in Uganda (IUIU), Kampala, Uganda
| | - Charles Ibingira
- Department of Human Anatomy, Makerere University, Kampala, Uganda
| | - Michael Lubwama
- Department of Mechanical Engineering, Makerere University, Kampala, Uganda
| | | | - Robert Tamale Ssekitoleko
- Department of Medical Physiology, Biomedical Engineering Program, Makerere University, Kampala, Uganda
| |
Collapse
|
7
|
Ryan RE, Silke C, Parkhill A, Virgona A, Merner B, Hurley S, Walsh L, de Moel-Mandel C, Schonfeld L, Edwards AG, Kaufman J, Cooper A, Chung RKY, Solo K, Hellard M, Di Tanna GL, Pedrana A, Saich F, Hill S. Communication to promote and support physical distancing for COVID-19 prevention and control. Cochrane Database Syst Rev 2023; 10:CD015144. [PMID: 37811673 PMCID: PMC10561351 DOI: 10.1002/14651858.cd015144] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
BACKGROUND This review is an update of a rapid review undertaken in 2020 to identify relevant, feasible and effective communication approaches to promote acceptance, uptake and adherence to physical distancing measures for COVID-19 prevention and control. The rapid review was published when little was known about transmission, treatment or future vaccination, and when physical distancing measures (isolation, quarantine, contact tracing, crowd avoidance, work and school measures) were the cornerstone of public health responses globally. This updated review includes more recent evidence to extend what we know about effective pandemic public health communication. This includes considerations of changes needed over time to maintain responsiveness to pandemic transmission waves, the (in)equities and variable needs of groups within communities due to the pandemic, and highlights again the critical role of effective communication as integral to the public health response. OBJECTIVES To update the evidence on the question 'What are relevant, feasible and effective communication approaches to promote acceptance, uptake and adherence to physical distancing measures for COVID-19 prevention and control?', our primary focus was communication approaches to promote and support acceptance, uptake and adherence to physical distancing. SECONDARY OBJECTIVE to explore and identify key elements of effective communication for physical distancing measures for different (diverse) populations and groups. SEARCH METHODS We searched MEDLINE, Embase and Cochrane Library databases from inception, with searches for this update including the period 1 January 2020 to 18 August 2021. Systematic review and study repositories and grey literature sources were searched in August 2021 and guidelines identified for the eCOVID19 Recommendations Map were screened (November 2021). SELECTION CRITERIA Guidelines or reviews focusing on communication (information, education, reminders, facilitating decision-making, skills acquisition, supporting behaviour change, support, involvement in decision-making) related to physical distancing measures for prevention and/or control of COVID-19 or selected other diseases (sudden acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), influenza, Ebola virus disease (EVD) or tuberculosis (TB)) were included. New evidence was added to guidelines, reviews and primary studies included in the 2020 review. DATA COLLECTION AND ANALYSIS Methods were based on the original rapid review, using methods developed by McMaster University and informed by Cochrane rapid review guidance. Screening, data extraction, quality assessment and synthesis were conducted by one author and checked by a second author. Synthesis of results was conducted using modified framework analysis, with themes from the original review used as an initial framework. MAIN RESULTS This review update includes 68 studies, with 17 guidelines and 20 reviews added to the original 31 studies. Synthesis identified six major themes, which can be used to inform policy and decision-making related to planning and implementing communication about a public health emergency and measures to protect the community. Theme 1: Strengthening public trust and countering misinformation: essential foundations for effective public health communication Recognising the key role of public trust is essential. Working to build and maintain trust over time underpins the success of public health communications and, therefore, the effectiveness of public health prevention measures. Theme 2: Two-way communication: involving communities to improve the dissemination, accessibility and acceptability of information Two-way communication (engagement) with the public is needed over the course of a public health emergency: at first, recognition of a health threat (despite uncertainties), and regularly as public health measures are introduced or adjusted. Engagement needs to be embedded at all stages of the response and inform tailoring of communications and implementation of public health measures over time. Theme 3: Development of and preparation for public communication: target audience, equity and tailoring Communication and information must be tailored to reach all groups within populations, and explicitly consider existing inequities and the needs of disadvantaged groups, including those who are underserved, vulnerable, from diverse cultural or language groups, or who have lower educational attainment. Awareness that implementing public health measures may magnify existing or emerging inequities is also needed in response planning, enactment and adjustment over time. Theme 4: Public communication features: content, timing and duration, delivery Public communication needs to be based on clear, consistent, actionable and timely (up-to-date) information about preventive measures, including the benefits (whether for individual, social groupings or wider society), harms (likewise) and rationale for use, and include information about supports available to help follow recommended measures. Communication needs to occur through multiple channels and/or formats to build public trust and reach more of the community. Theme 5: Supporting behaviour change at individual and population levels Supporting implementation of public health measures with practical supports and services (e.g. essential supplies, financial support) is critical. Information about available supports must be widely disseminated and well understood. Supports and communication related to them require flexibility and tailoring to explicitly consider community needs, including those of vulnerable groups. Proactively monitoring and countering stigma related to preventive measures (e.g. quarantine) is also necessary to support adherence. Theme 6: Fostering and sustaining receptiveness and responsiveness to public health communication Efforts to foster and sustain public receptiveness and responsiveness to public health communication are needed throughout a public health emergency. Trust, acceptance and behaviours change over time, and communication needs to be adaptive and responsive to these changing needs. Ongoing community engagement efforts should inform communication and public health response measures. AUTHORS' CONCLUSIONS Implications for practice Evidence highlights the critical role of communication throughout a public health emergency. Like any intervention, communication can be done well or poorly, but the consequences of poor communication during a pandemic may mean the difference between life and death. The approaches to effective communication identified in this review can be used by policymakers and decision-makers, working closely with communication teams, to plan, implement and adjust public communications over the course of a public health emergency like the COVID-19 pandemic. Implications for research Despite massive growth in research during the COVID-19 period, gaps in the evidence persist and require high-quality, meaningful research. This includes investigating the experiences of people at heightened COVID-19 risk, and identifying barriers to implementing public communication and protective health measures particular to lower- and middle-income countries, and how to overcome these.
Collapse
Affiliation(s)
- Rebecca E Ryan
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Charlotte Silke
- UNESCO Child & Family Research Centre, School of Political Science & Sociology, University of Galway, Galway, Ireland
| | - Anne Parkhill
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Ariane Virgona
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Bronwen Merner
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Shauna Hurley
- Cochrane Australia, School of Public Health & Preventive Medicine, Melbourne, Australia
| | - Louisa Walsh
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
- Department of Nursing and Allied Health, Swinburne University of Technology, Hawthorn, Australia
- Burnet Institute, Melbourne, Australia
| | | | - Lina Schonfeld
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Adrian Gk Edwards
- Wales COVID-19 Evidence Centre, Cardiff University, 8th floor Neuadd Meirionnydd, Heath Park, Cardiff CF14 4XN , UK
- PRIME Centre Wales, Division of Population Medicine, School of Medicine, 8th floor Neuadd Meirionnydd, Heath Park, Cardiff CF14 4XN, UK
| | - Jessica Kaufman
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
- Vaccine Uptake Group, Murdoch Children's Research Institute , The Royal Children's Hospital, Parkville, Australia
| | - Alison Cooper
- Wales COVID-19 Evidence Centre, Cardiff University, 8th floor Neuadd Meirionnydd, Heath Park, Cardiff CF14 4XN , UK
- PRIME Centre Wales, Division of Population Medicine, School of Medicine, 8th floor Neuadd Meirionnydd, Heath Park, Cardiff CF14 4XN, UK
| | | | - Karla Solo
- GRADE McMaster & Cochrane Canada, Health Research Methods, Evidence & Impact, McMaster University , Hamilton, Ontario , Canada
| | | | - Gian Luca Di Tanna
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Lugano, Switzerland
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | | | | | - Sophie Hill
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| |
Collapse
|
8
|
Elgarten CW, Kairalla JA, Thompson JC, Miller TP, Wang C, Conway S, Loh ML, Raetz EA, Gupta S, Rau RE, Angiolillo A, Rabin KR, Alexander S. SARS-CoV-2 infections in patients enrolled on the Children's Oncology Group standard-risk B-cell acute lymphoblastic leukemia trial, AALL1731. EJHAEM 2023; 4:745-750. [PMID: 37601850 PMCID: PMC10435702 DOI: 10.1002/jha2.697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 04/11/2023] [Accepted: 04/13/2023] [Indexed: 08/22/2023]
Abstract
Hematologic malignancy is a risk factor for severe coronavirus disease 2019 (COVID-19) in adults; however, data specific to children with leukemia are limited. High-quality infectious adverse event data from the ongoing Children's Oncology Group (COG) standard-risk B acute lymphoblastic leukemia/lymphoma (ALL/LLy) trial, AALL1731, were analyzed to provide a disease-specific estimate of SARS-CoV-2 infection outcomes in pediatric ALL. Of 253 patients with reported infections, the majority (77.1%) were asymptomatic or mildly symptomatic (CTCAE grade 1/2) and there was a single COVID-19-related death. These data suggest SARS-CoV-2 infection does not confer substantial morbidity among young patients with B-lymphoblastic leukemia/lymphoma (B-ALL/LLy).
Collapse
Affiliation(s)
- Caitlin W. Elgarten
- Department of PediatricsDivision of OncologyChildren's Hospital of PhiladelphiaPhiladelphiaPennsylvaniaUSA
| | - John A. Kairalla
- Department of BiostatisticsUniversity of FloridaGainesvilleFloridaUSA
| | - Joel C. Thompson
- Department of PediatricsDivision of Hematology/Oncology/Bone Marrow TransplantChildren's Mercy HospitalUniversity of Missouri ‐ Kansas CityKansas CityMissouriUSA
| | - Tamara P. Miller
- Pediatric Hematology/OncologyChildren's Healthcare of Atlanta ‐ EglestonAtlantaGeorgiaUSA
| | - Cindy Wang
- Department of BiostatisticsUniversity of FloridaGainesvilleFloridaUSA
| | - Susan Conway
- Department of BiostatisticsUniversity of FloridaGainesvilleFloridaUSA
| | - Mignon L. Loh
- Ben Towne Center for Childhood Cancer ResearchSeattle Children's Research Institute and Department of PediatricsSeattle Children's HospitalUniversity of WashingtonSeattleWashingtonUSA
| | - Elizabeth A. Raetz
- Laura and Isaac Perlmutter Cancer Center at NYU LangoneNew YorkNew YorkUSA
| | - Sumit Gupta
- Division of Hematology/OncologyHospital for Sick ChildrenTorontoOntarioCanada
| | - Rachel E. Rau
- Pediatric Hematology/OncologyBaylor College of MedicineHoustonTexasUSA
| | - Anne Angiolillo
- Center for Cancer and Blood DisordersChildren's National Medical CenterWashingtonDistrict of ColumbiaUSA
| | - Karen R. Rabin
- Pediatric Hematology/OncologyBaylor College of MedicineHoustonTexasUSA
| | - Sarah Alexander
- Division of Hematology/OncologyHospital for Sick ChildrenTorontoOntarioCanada
| |
Collapse
|
9
|
Roy P, van Peer SE, Dandis R, Duncan C, de Aguirre‐Neto JC, Verschuur A, de Camargo B, Karim‐Kos HE, Boschetti L, Spreafico F, Ramirez‐Villar GL, Graf N, van Tinteren H, Pritchard‐Jones K, van den Heuvel‐Eibrink MM. Impact of the COVID-19 pandemic on paediatric renal tumour presentation and management, a SIOP renal tumour study group study. Cancer Med 2023; 12:17098-17111. [PMID: 37496317 PMCID: PMC10501283 DOI: 10.1002/cam4.6358] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 06/26/2023] [Accepted: 07/09/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic had global catastrophic effects on the management of non-communicable diseases including paediatric cancers. Restrictions during the start of 2020 complicated timely referrals of patients to specialized centres. We aimed to evaluate the pandemic's impact on the number of new diagnoses, disease characteristics and management delay for paediatric renal tumour patients included in the SIOP-RTSG-UMBRELLA study, as compared with data from a historical SIOP-RTSG trial (2005-2009). METHODS The number of intensive care admissions, population mobility rates and national lockdown periods/restrictions were used as proxies of the pandemic's severity and impact on societies. Clinical and tumour data were extracted from the SIOP-RTSG-UMBRELLA study and from historical SIOP-RTSG trials. RESULTS During the first lockdown in Europe, the number of newly diagnosed patients decreased following restrictions and population immobilisation. Additionally, there was a higher proportion of advanced disease (37% vs. 17% before and after COVID-9, p < 0.001) and larger median tumour volume (559 cm3 vs. 328 and 434 cm3 before and after, p < 0.0001). Also in Brazil, the proportion of advanced disease was higher during the national decrease in mobilisation and start of restrictions (50% and 24% vs. 11% and 18% before and after, p < 0.01). Tumour volume in Brazil was also higher during the first months of COVID-19 (599 cm3 vs. 459 and 514 cm3 ), although not significant (p = 0.17). We did not observe any delays in referral time nor in time to start treatment, even though COVID-19 restrictions may have caused children to reach care later. CONCLUSION The COVID-19 pandemic briefly changed the tumour characteristics of children presenting with renal tumours. The longer-term impact on clinical outcomes will be kept under review.
Collapse
Affiliation(s)
- Prakriti Roy
- Princess Máxima Center for Pediatric OncologyUtrechtThe Netherlands
| | | | - Rana Dandis
- Princess Máxima Center for Pediatric OncologyUtrechtThe Netherlands
| | | | | | - Arnauld Verschuur
- Department of Paediatric Oncology & HaematologyLa Timone Children's HospitalMarseilleFrance
| | - Beatriz de Camargo
- Grupo Brasileiro de Tumores Renais (Brazilian Renal Tumor Group)São PauloBrazil
| | - Henrike E. Karim‐Kos
- Princess Máxima Center for Pediatric OncologyUtrechtThe Netherlands
- Department of ResearchNetherlands Comprehensive Cancer Organisation (IKNL)UtrechtThe Netherlands
| | - Luna Boschetti
- Department of Medical Oncology and Hematology, Pediatric Oncology UnitFondazione IRCCS Istituto Nazionale dei Tumori di MilanMilanItaly
| | - Filippo Spreafico
- Department of Medical Oncology and Hematology, Pediatric Oncology UnitFondazione IRCCS Istituto Nazionale dei Tumori di MilanMilanItaly
| | | | - Norbert Graf
- Department of Paediatric Oncology & HaematologySaarland UniversityHomburgGermany
| | | | - Kathy Pritchard‐Jones
- UCL Great Ormond Street Institute of Child Health, University College LondonLondonUK
| | - Marry M. van den Heuvel‐Eibrink
- Princess Máxima Center for Pediatric OncologyUtrechtThe Netherlands
- Division of Child Health, Wilhelmina Children's HospitalUniversity Medical Center UtrechtThe Netherlands
| |
Collapse
|
10
|
Young K, Cashion C, Hassall T, Ekberg S, Bradford N. Supporting families through paediatric brain tumour: Unmet needs and suggestions for change. Psychooncology 2023; 32:942-950. [PMID: 37081572 PMCID: PMC10946516 DOI: 10.1002/pon.6136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 03/31/2023] [Accepted: 04/04/2023] [Indexed: 04/22/2023]
Abstract
OBJECTIVE From diagnosis and beyond, a paediatric brain tumour and its treatment impact the child and their family in a myriad of ways. While it is considered best practice to offer ongoing psychosocial support for all family members, there is little scholarly investigation of both families' experiences and the practical implications of offering such care. We aimed to explore families' experiences of paediatric brain tumour and their associated psychosocial health service needs. METHODS Families receiving care at the Queensland Children's Hospital in Brisbane, Australia, for a child (0-18 years) who had been diagnosed with a brain tumour between 2019 and 2022 were invited to be interviewed about their experiences. Using qualitative description, we analysed these interviews to identify families' unmet psychosocial health service needs and their suggestions for improvement. RESULTS Twenty-three clinically and socially diverse families were represented. While parents/carers expressed gratitude for the care their child had received, most also described unmet needs for the broader family. We identified three primary needs to be addressed: (1) parents want accessible psychological/emotional support for themselves; (2) parents/carers want additional guidance to navigate the hospital setting to reduce uncertainty and loss of control; and (3) parents want support to minimise treatment-associated trauma for their child. CONCLUSIONS Our findings evidence the need for improved family-centred psychosocial care within paediatric brain tumour care in Queensland, Australia. We propose a counselling and care coordination intervention to support parents/carers to care for themselves, their child, and their family through an extremely challenging experience.
Collapse
Affiliation(s)
- Kate Young
- Cancer and Palliative Care Outcomes CentreCentre for Healthcare TransformationQueensland University of TechnologyBrisbaneQueenslandAustralia
- Centre for Children's Health ResearchChildren's Health Queensland Hospital and Health ServiceSouth BrisbaneQueenslandAustralia
| | - Christine Cashion
- Centre for Children's Health ResearchChildren's Health Queensland Hospital and Health ServiceSouth BrisbaneQueenslandAustralia
- Children's Health Queensland Hospital and Health ServiceSouth BrisbaneQueenslandAustralia
| | - Timothy Hassall
- Children's Health Queensland Hospital and Health ServiceSouth BrisbaneQueenslandAustralia
| | - Stuart Ekberg
- Children's Health Queensland Hospital and Health ServiceSouth BrisbaneQueenslandAustralia
- School of Psychology & CounsellingQueensland University of TechnologyBrisbaneQueenslandAustralia
| | - Natalie Bradford
- Cancer and Palliative Care Outcomes CentreCentre for Healthcare TransformationQueensland University of TechnologyBrisbaneQueenslandAustralia
- Centre for Children's Health ResearchChildren's Health Queensland Hospital and Health ServiceSouth BrisbaneQueenslandAustralia
| |
Collapse
|
11
|
Ali N, Ghalibafian M, Sykes-Martin K, Parkes J, Qureshi B, Esiashvili N. Impact of COVID-19 pandemic on delivery of pediatric radiotherapy: A critical review. Pediatr Blood Cancer 2023:e30446. [PMID: 37243393 DOI: 10.1002/pbc.30446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 04/21/2023] [Accepted: 05/06/2023] [Indexed: 05/28/2023]
Abstract
The COVID-19 pandemic has prevented the timely diagnosis and treatment of many diseases, including pediatric cancer. Its impact on pediatric oncologic treatments warrants investigation. As radiotherapy is an integral component of cancer care, we reviewed the published data regarding the impact of COVID-19 on the delivery of pediatric radiotherapy to inform actions for future global events. We found that disruptions in radiotherapy were reported amongst interruptions in other therapies. Disruptions were more common in low-income countries (78%) and low middle-income countries (68%) compared with upper middle-income countries (46%) and high-income countries (10%). Several papers included recommendations for mitigation strategies. Altered treatment regimens were common, including increasing the use of active surveillance and systemic therapy to delay local therapies, and accelerated/hypofractionated dose delivery. Our findings suggest that COVID-19 has impacted radiotherapy delivery in the pediatric population globally. Countries with limited resources may be more affected. Various mitigation strategies have been developed. The efficacy of mitigation measures warrants further investigation.
Collapse
Affiliation(s)
- Naba Ali
- Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Mithra Ghalibafian
- Mahak Pediatric Cancer Treatment and Research Center, Radiation Oncology, Tehran, Iran
| | | | - Jeannette Parkes
- Radiation Oncology, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
| | - Bilal Qureshi
- Radiation Oncology, The Aga Khan University, Karachi, Pakistan
| | - Natia Esiashvili
- Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| |
Collapse
|
12
|
Katato GK, Sitaula P, Gupte A, Al-Antary ET. The Impact of COVID-19 on Pediatric Malignancy Diagnosis and Treatment: Never the Same but Lessons Learned. Vaccines (Basel) 2023; 11:vaccines11030667. [PMID: 36992251 DOI: 10.3390/vaccines11030667] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 03/07/2023] [Accepted: 03/08/2023] [Indexed: 03/18/2023] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic affected the pediatric oncology population globally. Over the course of 2 years, increasing reports have been made to better understand this entity and its pathologic complications on these patients. The pandemic has allowed healthcare providers, hospital systems, and leading oncologic societies to quickly adapt and formulate new guidelines for the effective understanding, management, and treatment of patients with pediatric malignancy.
Collapse
Affiliation(s)
- Ghadir K Katato
- Division of Hematology/Oncology, Children's Hospital of Michigan, Detroit, MI 48201, USA
- Department of Pediatrics, Central Michigan University College of Medicine, Mt Clemons, MI 48603, USA
| | - Prasiksha Sitaula
- Division of Hematology/Oncology, Children's Hospital of Michigan, Detroit, MI 48201, USA
- Department of Pediatrics, Central Michigan University College of Medicine, Mt Clemons, MI 48603, USA
| | - Avanti Gupte
- Division of Hematology/Oncology, Children's Hospital of Michigan, Detroit, MI 48201, USA
- Department of Pediatrics, Central Michigan University College of Medicine, Mt Clemons, MI 48603, USA
- Pediatric Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Barbara Ann Karmanos Cancer Center, Children's Hospital of Michigan, Detroit, MI 48201, USA
| | - Eman T Al-Antary
- Division of Hematology/Oncology, Children's Hospital of Michigan, Detroit, MI 48201, USA
- Department of Pediatrics, Central Michigan University College of Medicine, Mt Clemons, MI 48603, USA
- Pediatric Blood and Marrow Transplantation Program, Division of Hematology/Oncology, Barbara Ann Karmanos Cancer Center, Children's Hospital of Michigan, Detroit, MI 48201, USA
| |
Collapse
|
13
|
Tran A, Hou SHJ, Forbes C, Cho S, Forster VJ, Stokoe M, Wakefield CE, Wiener L, Heathcote LC, Michel G, Patterson P, Reynolds K, Schulte FSM. The Impact of the Early COVID-19 Global Pandemic on Children Undergoing Active Cancer Treatment and Their Parents. Curr Oncol 2023; 30:2441-2456. [PMID: 36826147 PMCID: PMC9954946 DOI: 10.3390/curroncol30020186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/12/2023] [Accepted: 02/13/2023] [Indexed: 02/22/2023] Open
Abstract
(1) Background: The COVID-19 global pandemic has impacted people worldwide with unique implications for vulnerable groups. In this cross-sectional study, we examined the impact of the early pandemic on children undergoing active cancer treatment and their parents. (2) Methods: In May 2020, 30 parents of children undergoing active cancer treatment completed an online survey regarding the impact of COVID-19 on their child's cancer care, perceived utility of telemedicine, and child and parent mental health status. (3) Results: Most participants (87%) reported that they did not experience any changes to major cancer treatments. Among those who reported using telemedicine, 78% reported this to be beneficial. Over half of the participants reported that their child's mental health status was worse now than prior to the COVID-19 global pandemic. Parent-reported child anxiety scores were significantly higher for those who reported changes to mental health care for their child compared to those who did not report the same, t(25.99) = -3.04, p = 0.005. (4) Conclusion: Child and parent mental health status were affected when compared to pre-pandemic. Telemedicine appears to be a promising complement to face-to-face meetings for some families and warrants further exploration.
Collapse
Affiliation(s)
- Andrew Tran
- Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Sharon H. J. Hou
- Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Department of Psychology, British Columbia Children’s Hospital, Vancouver, BC V6H 3N1, Canada
| | - Caitlin Forbes
- Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Sara Cho
- Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Victoria J. Forster
- Arthur and Sonia Labatt Brain Tumour Research Centre, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Mehak Stokoe
- Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Claire E. Wakefield
- School of Women’s and Children’s Health, UNSW Medicine and Health, UNSW Sydney, Sydney, NSW 2052, Australia
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
| | - Lori Wiener
- Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Lauren C. Heathcote
- Health Psychology Section, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London WC2R 2LS, UK
| | - Gisela Michel
- Department of Health Sciences and Medicine, University of Lucerne, 6002 Lucerne, Switzerland
| | - Pandora Patterson
- Research, Evaluation and Policy Unit, Canteen Australia, Sydney, NSW 2042, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
| | - Kathleen Reynolds
- Long Term Survivor’s Clinic, Alberta Children’s Hospital, Calgary, AB T3B 6A8, Canada
- Department of Medicine, Faculty of Family Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Fiona S. M. Schulte
- Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Long Term Survivor’s Clinic, Alberta Children’s Hospital, Calgary, AB T3B 6A8, Canada
- Correspondence:
| |
Collapse
|
14
|
Koç BŞ, Tekkeşin F, Haccaloğlu EE, Beyter B, Aydoğdu S, Çakı Kılıç S, Caki Kilic S. Any Concern About Delays in the Diagnosis of Childhood Cancers During the COVID-19 Pandemic? Turk Arch Pediatr 2023; 58:75-79. [PMID: 36598215 PMCID: PMC9885817 DOI: 10.5152/turkarchpediatr.2022.22224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE The lockdown precautions during the COVID-19 pandemic led to concerns about the delayed diagnosis of malignancies. This study aimed to compare the duration of complaints at home and the presence of metastasis at diagnosis during the pre-pandemic and pandemic period in children with cancer. MATERIALS AND METHODS All children diagnosed with cancer and followed up in our clinic between 2017 and 2022 were included. Patients with a diagnosis of acute/chronic leukemia were excluded. Age, gender, cancer type, duration of complaints, and presence of metastasis at diagnosis of the children were recorded. The duration of complaints and presence of metastasis at diagnosis were compared statistically before and after March 11, 2020, the start point of the COVID-19 pandemic in our country. RESULTS A total of 161 patients diagnosed with cancer were analyzed retrospectively; 61% of patients were males and 39% were females. These patients were diagnosed with brain tumors (23.6%), lymphomas (23%), neuroblastoma (13.7%), rhabdomyosarcomas (10.6%), Ewing's sarcoma (4.3%), osteosarcoma (3.7%), Wilm's tumor (3.7%), and germ cell tumors (3.1%). The duration of complaint was longer during the pandemic than before the pandemic (median: 45 days vs. 30 days) (P < .05). The presence of metastases at diagnosis was 45.3% in the prepandemic period, while it was 40% during the pandemic with no statistical difference (P > .5). CONCLUSION We concluded that the duration of complaint before diagnosis was longer during the pandemic, while this delay did not affect the metastasis rate at diagnosis in children with cancer. The high rates of distant metastases in newly diagnosed patients both before and during the pandemic suggest that more studies are needed to diagnose these patients earlier.
Collapse
Affiliation(s)
- Begüm Şirin Koç
- Department of Pediatric Hematology and Oncology, University of Health Sciences, Ümraniye Research and Training Hospital, İstanbul, Turkey,Corresponding author:Begüm Şirin Koç ✉
| | - Funda Tekkeşin
- Department of Pediatric Hematology and Oncology, University of Health Sciences, Ümraniye Research and Training Hospital, İstanbul, Turkey
| | - Elif Ezgi Haccaloğlu
- Department of Pediatrics, University of Health Sciences, Ümraniye Research and Training Hospital, İstanbul, Turkey
| | - Büşra Beyter
- Department of Pediatrics, University of Health Sciences, Ümraniye Research and Training Hospital, İstanbul, Turkey
| | - Selime Aydoğdu
- Department of Pediatric Hematology and Oncology, University of Health Sciences, Ümraniye Research and Training Hospital, İstanbul, Turkey
| | - Suar Çakı Kılıç
- Department of Pediatric Hematology and Oncology, University of Health Sciences, Ümraniye Research and Training Hospital, İstanbul, Turkey
| | | | | | | | | | | | | |
Collapse
|
15
|
Mohapatra S, Das PK, Mishra B, Panigrahi A. Clinical review of COVID-19 in children and adolescents with cancer: Experience from a tertiary care center in East India. Pediatr Hematol Oncol 2022; 39:517-528. [PMID: 35156866 DOI: 10.1080/08880018.2022.2025963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Children with underlying cancer are often immunocompromised. Data on severity of coronavirus disease 2019 (COVID-19) in children with cancer and its outcomes is emerging. Treatment protocols of specific cancers are decided based on the infrastructure, availability of supportive-care, and logistic issues of the locality. The purpose of the study was clinical analysis of COVID-19 in children and adolescents with cancer. The retrospective observational study was conducted at a tertiary healthcare-center in East India. Children and adolescents (aged 0-19 years) with cancer and under treatment with reverse-transcriptase-polymerase-chain-reaction (RT-PCR) confirmed COVID-19 between 5-July-2020 and 5-December-2020 were studied. Median age of the 68 identified patients was six years. Acute leukemia was the most common (66%) diagnosis. COVID-19 was asymptomatic/mildly symptomatic in 91% and moderate to severe in only 9% of patients. Fever (87%) was the commonest symptom, followed-by cough/coryza (75%). Three patients with acute myeloid leukemia (AML) and severe/critical COVID-19 and associated neutropenic sepsis were required transfer to the intensive-care-unit (ICU) for management. Three (4.4%) patients succumbed with COVID-19. Delay in treatment was observed in 63.2% of patients, and the median duration of delay was 28 days after acquiring COVID-19. Median time to attain negative COVID-19 RT-PCR was 16 days, and eight patients were repeat positives. While pediatric and adolescent cancer patients on active treatment may have a higher risk of mortality from severe COVID-19 than their healthy counterparts, the risk may be much lower than deemed. It is essential to continue cancer therapy in these children. Delay in treatment remains a concern.
Collapse
Affiliation(s)
- Sonali Mohapatra
- Department of Medical Oncology/Hematology, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Prabodh Kumar Das
- Department of Medical Oncology/Hematology, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Baijayantimala Mishra
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Ashutosh Panigrahi
- Department of Medical Oncology/Hematology, All India Institute of Medical Sciences, Bhubaneswar, India
| |
Collapse
|
16
|
Sundland R, Essig R, Bachier-Rodriguez M. Lessons Learned from the Surgical Management of Childhood Cancers During the COVID-19 Pandemic. Pediatr Ann 2022; 51:e270-e276. [PMID: 35858216 DOI: 10.3928/19382359-20220504-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Globally, there have been more than 285 million confirmed cases of coronavirus disease 2019 (COVID-19), with nearly 5.5 million deaths. Centers for Disease Control and Prevention data report that in the United States alone, there have been more than 59 million cases of COVID-19 with more than 800,000 lives lost as of January 2022. Similar to other health care specialties, pediatric surgery departments have modified their treatment approach to delivering timely care while respecting resource allocation during the pandemic. In this review, we focus on the surgical management of pediatric patients, with specific attention to childhood cancer. The primary subject of this review is the development of triaging methods for patients with childhood cancer for surgical procedures and precautionary measures for operating on patients with COVID-19. [Pediatr Ann. 2022;51():e270-e276.].
Collapse
|
17
|
Favorable outcome of SARS-CoV-2 infection in pediatric hematology oncology patients during the second and third pandemic waves in Italy: a multicenter analysis from the Infectious Diseases Working Group of the Associazione Italiana di Ematologia e Oncologia Pediatrica (AIEOP). Ann Hematol 2022; 101:1843-1851. [PMID: 35726104 PMCID: PMC9208706 DOI: 10.1007/s00277-022-04884-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 06/01/2022] [Indexed: 12/02/2022]
Abstract
COVID-19 has a mild clinical course with low mortality rate in general pediatric population, while variable outcomes have been described in children with cancer. Infectious diseases working party of the AIEOP collected data on the clinical characteristics and outcomes of SARS-CoV-2 infections in pediatric oncology/hematology patients from April 2020 to May 2021, including the second and the third waves of the pandemic in Italy. Factors potentially associated with moderate, severe, or critical COVID-19 were analyzed. Of the 153 SARS-Cov2 infections recorded, 100 were asymptomatic and 53 symptomatic. The course of COVID-19 was mild in 41, moderate in 2, severe in 5, and critical in 5 children. A total of 40.5% of patients were hospitalized, ten requiring oxygen support and 5 admitted to the intensive care unit. Antibiotics and steroids were the most used therapies. No patient died due to SARS-CoV-2 infection. Infections occurring early (< 60 days) after the diagnosis of the underlying disease or after SCT were associated to moderate, severe, and critical disease compared to infections occurring late (> 60 days) or during maintenance therapy. In the patients on active chemotherapy, 59% withdrew the treatment for a median of 15 days. SARS-CoV-2 presented a favorable outcome in children with cancer in Italy during the pandemic. Modification of therapy represents a major concern in this population. Our findings suggest considering regular chemotherapy continuation, particularly in patients on maintenance therapy or infected late after the diagnosis.
Collapse
|
18
|
Pritchard-Jones K, Challinor JM, Hunger SP, Sung L, Davidson A, Morrissey LK, Khan MS, Dalvi RB, Sullivan MJ, Hessissen L, Chantada GL, Kearns P, Frazier AL, Wollaert S, Laub T. SIOP Strategy 2021-2025: Cure for more, care for all. Pediatr Blood Cancer 2022; 69:e29577. [PMID: 35166434 DOI: 10.1002/pbc.29577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Kathy Pritchard-Jones
- University College London Great Ormond Street Institute of Child Health, London, United Kingdom
| | | | | | | | - Alan Davidson
- Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa
| | | | | | - Rashmi B Dalvi
- Bombay Hospital Institute of Medical Sciences SRCC Children's Hospital, Mumbai, India
| | - Michael J Sullivan
- Children's Cancer Centre, Royal Children's Hospital, Melbourne, Australia
| | | | | | - Pamela Kearns
- Cancer Research UK Clinical Trials Unit, Institute of Cancer and Genomic Sciences, University of Birmingham, United Kingdom
| | | | - Susanne Wollaert
- Executive Director, International Society of Paediatric Oncology, Meierskappel, Switzerland
| | - Tzvetomira Laub
- Executive Director for Programmes and Strategy, International Society of Paediatric Oncology, Meierskappel, Switzerland
| |
Collapse
|
19
|
Dominguez-Rojas JÁ, Vásquez-Hoyos P, Pérez-Morales R, Monsalve-Quintero AM, Mora-Robles L, Diaz-Diaz A, Torres SF, Castro-Dajer Á, Cabanillas-Burgos LY, Aguilera-Avendaño V, Cantillano-Quintero EM, Camporesi A, Agulnik A, Mukkada S, Alvarado-Gamarra G, Rojas-Soto N, Mendieta-Zevallos AL, Tello-Pezo MV, Vásquez-Ponce L, Lasso-Palomino RE, Pérez-Arroyave MC, Trujillo-Honeysberg M, Mesa-Monsalve JG, Pardo González CA, López Cubillos JF, Gonzalez-Dambrauskas S, Coronado-Munoz A. Association of Cancer Diagnosis and Therapeutic Stage With Mortality in Pediatric Patients With COVID-19, Prospective Multicenter Cohort Study From Latin America. Front Pediatr 2022; 10:885633. [PMID: 35592840 PMCID: PMC9110860 DOI: 10.3389/fped.2022.885633] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 04/13/2022] [Indexed: 11/13/2022] Open
Abstract
Background Children with cancer are at risk of critical disease and mortality from COVID-19 infection. In this study, we describe the clinical characteristics of pediatric patients with cancer and COVID-19 from multiple Latin American centers and risk factors associated with mortality in this population. Methods This study is a multicenter, prospective cohort study conducted at 12 hospitals from 6 Latin American countries (Argentina, Bolivia, Colombia, Ecuador, Honduras and Peru) from April to November 2021. Patients younger than 14 years of age that had an oncological diagnosis and COVID-19 or multisystemic inflammatory syndrome in children (MIS-C) who were treated in the inpatient setting were included. The primary exposure was the diagnosis and treatment status, and the primary outcome was mortality. We defined "new diagnosis" as patients with no previous diagnosis of cancer, "established diagnosis" as patients with cancer and ongoing treatment and "relapse" as patients with cancer and ongoing treatment that had a prior cancer-free period. A frequentist analysis was performed including a multivariate logistic regression for mortality. Results Two hundred and ten patients were included in the study; 30 (14%) died during the study period and 67% of patients who died were admitted to critical care. Demographics were similar in survivors and non-survivors. Patients with low weight for age (<-2SD) had higher mortality (28 vs. 3%, p = 0.019). There was statistically significant difference of mortality between patients with new diagnosis (36.7%), established diagnosis (1.4%) and relapse (60%), (p <0.001). Most patients had hematological cancers (69%) and they had higher mortality (18%) compared to solid tumors (6%, p= 0.032). Patients with concomitant bacterial infections had higher mortality (40%, p = 0.001). MIS-C, respiratory distress, cardiovascular symptoms, altered mental status and acute kidney injury on admission were associated with higher mortality. Acidosis, hypoxemia, lymphocytosis, severe neutropenia, anemia and thrombocytopenia on admission were also associated with mortality. A multivariate logistic regression showed risk factors associated with mortality: concomitant bacterial infection OR 3 95%CI (1.1-8.5), respiratory symptoms OR 5.7 95%CI (1.7-19.4), cardiovascular OR 5.2 95%CI (1.2-14.2), new cancer diagnosis OR 12 95%CI (1.3-102) and relapse OR 25 95%CI (2.9-214). Conclusion Our study shows that pediatric patients with new onset diagnosis of cancer and patients with relapse have higher odds of all-cause mortality in the setting of COVID-19. This information would help develop an early identification of patients with cancer and COVID-19 with higher risk of mortality.
Collapse
Affiliation(s)
- Jesus Ángel Dominguez-Rojas
- Pediatric Critical Care, Hospital Edgardo Rebagliati Martins, Red Colaborativa Pediátrica de Latinoamérica (LARed Network), Lima, Peru
| | - Pablo Vásquez-Hoyos
- Pediatric Critical Care, Hospital de San Jose, Red Colaborativa Pediátrica de Latinoamérica (LARed Network), Bogota, Colombia
- Research Division, Department of Pediatrics, Fundacion Universitatia de Ciencias de la Salud–FUCS, Bogota, Colombia
| | - Rodrigo Pérez-Morales
- Pediatric Critical Care, HOMI Fundacion Hospital Pediatrico La Misericordia, Bogota, Colombia
| | | | | | - Alejandro Diaz-Diaz
- Pediatric Infectious Diseases, Hospital Pablo Tobon Uribe y Hospital General de Medellin, Medellin, Colombia
| | - Silvio Fabio Torres
- Pediatric Critical Care, Hospital Universitario Austral Pilar, Buenos Aires, Argentina
| | | | | | | | | | - Anna Camporesi
- Department of Pediatric Anesthesia and Intensive Care, Vittore Buzzi Children's Hospital, Milano, Italy
| | - Asya Agulnik
- Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Sheena Mukkada
- Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Giancarlo Alvarado-Gamarra
- Pediatrics, Hospital Edgardo Rebagliati Martins, Lima, Peru
- Instituto de Investigación Nutricional, Lima, Perú
| | | | | | | | - Liliana Vásquez-Ponce
- Research Center “Medicina de Precisión, ” Facultad de Medicina, Universidad de San Martín de Porres, Lima, Perú
| | | | | | | | | | | | | | - Sebastián Gonzalez-Dambrauskas
- Specialized Pediatric Critical Care (CIPe), Casa de Galicia, Red Colaborativa Pediátrica de Latinoamérica (LARed Network), Montevideo, Uruguay
- Medical School, Pediatric Critical Care, Pereira Rossell Medical Center (UCIN-CHPR), Universidad de la República, Montevideo, Uruguay
| | - Alvaro Coronado-Munoz
- Pediatric Critical Care Division, Department of Pediatrics, University of Texas Health Science Center at Houston, Houston, TX, United States
| |
Collapse
|
20
|
Sarfraz S, Saeed H. Feasibility and safety of outpatient administration of ifosfamide and etoposide for pediatric patients with Ewing sarcoma in a resource-limited setting amid the COVID-19 pandemic. Pediatr Blood Cancer 2022; 69:e29595. [PMID: 35234343 PMCID: PMC9088619 DOI: 10.1002/pbc.29595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 12/23/2021] [Accepted: 01/10/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND To assess feasibility and safety of outpatient administration of ifosfamide and etoposide (IE) for pediatric Ewing sarcoma (EWS) patients in a resource-limited setting amid the COVID-19 pandemic. MATERIALS AND METHODS Retrospective study of patients with EWS who received outpatient IE from January 2020 until January 2021 at our institution. Ifosfamide 1800 mg/m2 was given for 5 days with MESNA (2-mercaptoethane sulfonate sodium) infusion and additional boluses before and after 9 hours of hydration. Patients >10 years of age with the ability to drink orally at home, no pre-existing renal dysfunction or history of hematuria were included. They were monitored for hemorrhagic cystitis with a urine dipstick before, midway, and at end of infusion. A urine analysis was done 24 hours after the last dose of ifosfamide. RESULTS Forty-seven (100%) cycles were given as outpatient during the study period. Thirty-five (74%) cycles were given on time, two (4%) cycles were delayed due to mucositis, two (4%) due to delayed count recovery, and eight (18%) due to unavailability of outpatient appointments. The median interval between these cycles was 15 days (range 14-44 days). No episode of hemorrhagic cystitis was reported. Urine analysis was not done at 24 hours for 27 (58%) cycles, so microscopic hematuria may have been missed. This outpatient protocol saved 32% (USD 299) per cycle in cost and 282 days of hospitalization. CONCLUSION Outpatient administration of IE for pediatric patients with EWS is feasible, safe, and cost-effective during the COVID-19 pandemic.
Collapse
Affiliation(s)
- Saliha Sarfraz
- Department of Paediatric OncologyShaukat Khanum Memorial Cancer Hospital and Research CentreLahorePakistan
| | - Haleema Saeed
- Department of Paediatric OncologyShaukat Khanum Memorial Cancer Hospital and Research CentreLahorePakistan
| |
Collapse
|
21
|
Majeed A, Wright T, Guo B, Arora RS, Lam CG, Martiniuk AL. The Global Impact of COVID-19 on Childhood Cancer Outcomes and Care Delivery - A Systematic Review. Front Oncol 2022; 12:869752. [PMID: 35463381 PMCID: PMC9023072 DOI: 10.3389/fonc.2022.869752] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 03/14/2022] [Indexed: 11/25/2022] Open
Abstract
Background Childhood cancer represents a leading cause of death and disease burden in high income countries (HICs) and low-and-middle income countries (LMICs). It is postulated that the current COVID-19 pandemic has hampered global development of pediatric oncology care programs. This systematic review aimed to comprehensively review the global impact of COVID-19 on childhood cancer clinical outcomes and care delivery. Methods A systematic search was conducted on PubMed, Embase, Medline, and the African Medical Index from inception to November 3, 2021 following PRISMA guidelines. A manual search was performed to identify additional relevant studies. Articles were selected based on predetermined eligibility criteria. Findings The majority of studies reported patients with cancer and COVID-19 presenting as asymptomatic (HICs: 33.7%, LMICs: 22.0%) or with primary manifestations of fever (HICs: 36.1%, LMICs: 51.4%) and respiratory symptoms (HICs: 29.6%, LMICs: 11.7%). LMICs also reported a high frequency of patients presenting with cough (23.6%) and gastrointestinal symptoms (10.6%). The majority of patients were generally noted to have a good prognosis; however the crude mortality rate was higher in LMICs when compared to HICs (8.0% vs 1.8%). Moreover, the pandemic has resulted in delays and interruptions to cancer therapies and delays in childhood cancer diagnoses in both HICs and LMICs. However, these findings were disproportionately reported in LMICs, with significant staff shortages, supply chain disruptions, and limited access to cancer therapies for patients. Conclusions The COVID-19 pandemic has resulted in delays and interruptions to childhood cancer therapies and delays in childhood cancer diagnoses, and disproportionately so within LMICs. This review provides lessons learned for future system-wide disruptions to care, as well as provides key points for moving forward better with care through the remainder of this pandemic. Systematic Review Registration CRD42021266758, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=266758
Collapse
Affiliation(s)
- Amna Majeed
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Tom Wright
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Biqi Guo
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Ramandeep S Arora
- Department of Medical Oncology, Max Super-Specialty Hospital, New Delhi, India
| | - Catherine G Lam
- Department of Global Pediatric Medicine and Oncology, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Alexandra L Martiniuk
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| |
Collapse
|
22
|
Bekar P, Erkul M, Efe E. Investigation of coronavirus anxiety and caregiving burden among the parents of children with cancer during the COVID‐19 outbreak: A descriptive and cross‐sectional study. Eur J Cancer Care (Engl) 2022; 31:e13600. [PMID: 35466488 PMCID: PMC9111339 DOI: 10.1111/ecc.13600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 02/07/2022] [Accepted: 04/18/2022] [Indexed: 11/28/2022]
Abstract
Objective This study aimed to investigate the coronavirus anxiety and caregiving burden of parents of children with cancer during the COVID‐19 outbreak. Methods This descriptive and cross‐sectional study, including 136 parents of children with cancer, was administered through an online survey at a university hospital from 1 to 31 January 2021. Participants completed a questionnaire form, the Zarit Caregiver Burden Scale and the Coronavirus Anxiety Scale. Results This study identified a significant difference in the caregiving burden scores of parents according to whether their relatives had been diagnosed with COVID‐19, whether they were exposed to coronavirus in their environment and whether their children had other illnesses. A significant difference in the coronavirus anxiety scores of parents was observed according to their child's sex and the time elapsed since their child's cancer diagnosis. No correlation was identified between the Zarit Caregiver Burden Scale scores and the Coronavirus Anxiety Scale scores. Conclusion Oncology nurses and other health professionals should be aware of and consider the factors that influence the caregiving burden and coronavirus‐related anxiety experienced by parents of children with cancer during the COVID‐19 outbreak.
Collapse
Affiliation(s)
- Pınar Bekar
- Bucak School of Health, Department of Child Development Burdur Mehmet Akif Ersoy University Bucak/Burdur Turkey
| | - Münevver Erkul
- Department of Paediatric Hematology‐Oncology Akdeniz University Hospital Antalya Turkey
| | - Emine Efe
- Nursing Faculty, Department of Child Health and Diseases Nursing Akdeniz University Antalya Turkey
| |
Collapse
|
23
|
Impact of the COVID-19 pandemic on patients with paediatric cancer in low-income, middle-income and high-income countries: a multicentre, international, observational cohort study. BMJ Open 2022; 12:e054690. [PMID: 35410925 PMCID: PMC9021459 DOI: 10.1136/bmjopen-2021-054690] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 01/21/2022] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Paediatric cancer is a leading cause of death for children. Children in low-income and middle-income countries (LMICs) were four times more likely to die than children in high-income countries (HICs). This study aimed to test the hypothesis that the COVID-19 pandemic had affected the delivery of healthcare services worldwide, and exacerbated the disparity in paediatric cancer outcomes between LMICs and HICs. DESIGN A multicentre, international, collaborative cohort study. SETTING 91 hospitals and cancer centres in 39 countries providing cancer treatment to paediatric patients between March and December 2020. PARTICIPANTS Patients were included if they were under the age of 18 years, and newly diagnosed with or undergoing active cancer treatment for Acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, Wilms' tumour, sarcoma, retinoblastoma, gliomas, medulloblastomas or neuroblastomas, in keeping with the WHO Global Initiative for Childhood Cancer. MAIN OUTCOME MEASURE All-cause mortality at 30 days and 90 days. RESULTS 1660 patients were recruited. 219 children had changes to their treatment due to the pandemic. Patients in LMICs were primarily affected (n=182/219, 83.1%). Relative to patients with paediatric cancer in HICs, patients with paediatric cancer in LMICs had 12.1 (95% CI 2.93 to 50.3) and 7.9 (95% CI 3.2 to 19.7) times the odds of death at 30 days and 90 days, respectively, after presentation during the COVID-19 pandemic (p<0.001). After adjusting for confounders, patients with paediatric cancer in LMICs had 15.6 (95% CI 3.7 to 65.8) times the odds of death at 30 days (p<0.001). CONCLUSIONS The COVID-19 pandemic has affected paediatric oncology service provision. It has disproportionately affected patients in LMICs, highlighting and compounding existing disparities in healthcare systems globally that need addressing urgently. However, many patients with paediatric cancer continued to receive their normal standard of care. This speaks to the adaptability and resilience of healthcare systems and healthcare workers globally.
Collapse
|
24
|
van Gorp M, Maurice-Stam H, Teunissen LC, Kilsdonk E, van Dijk J, Sulkers M, Tissing WJE, van Litsenburg RRL, Grootenhuis MA. Psychosocial function of Dutch children with cancer and their caregivers during different phases of the COVID-19 pandemic. Pediatr Blood Cancer 2022; 69:e29535. [PMID: 35107873 DOI: 10.1002/pbc.29535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 11/01/2021] [Accepted: 12/04/2021] [Indexed: 12/14/2022]
Abstract
We compared psychosocial functioning of children with cancer and their caregivers in several phases of the coronavirus disease 2019 (COVID-19) pandemic to before COVID-19. One or more questionnaires on health-related quality of life (HRQoL) or fatigue of children or distress of their caregivers was available from 1644 families. In children with cancer, HRQoL was stable throughout the COVID-19 pandemic. Fatigue was slightly lower and sleep somewhat better during the pandemic than before. Caregiver distress was lower in the first pandemic phase, but increased to pre-COVID-19 levels in later phases, indicating that the length and consequences of the pandemic may be weighing on them.
Collapse
Affiliation(s)
- Marloes van Gorp
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | | | - Layla C Teunissen
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Ellen Kilsdonk
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Jennifer van Dijk
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Mirjam Sulkers
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Wim J E Tissing
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.,Department of Pediatric Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | | | | |
Collapse
|
25
|
Isolated CNS Relapse in 2 High-Risk B-cell Acute Lymphoblastic Leukemia Patients Following SARS-CoV-2 Infection. J Pediatr Hematol Oncol 2022; 44:e723-e727. [PMID: 34935738 DOI: 10.1097/mph.0000000000002377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 11/04/2021] [Indexed: 11/25/2022]
Abstract
B-cell acute lymphoblastic leukemia (B-ALL) is the most common pediatric malignancy with a highly favorable overall prognosis. Central nervous system (CNS) relapse of B-ALL is relatively rare and is associated with inferior survival outcomes. We present two patients with B-ALL who developed isolated CNS relapse following confirmed infection with severe acute respiratory syndrome coronavirus 2. In addition to individual and disease factors, we posit that delays in therapy together with immune system modulation because of severe acute respiratory syndrome coronavirus 2 may account for these 2 cases of CNS relapsed B-ALL. We report on this clinical observation to raise awareness of this potential association.
Collapse
|
26
|
El-Qushayri AE, Benmelouka AY, Dahy A, Hashan MR. COVID-19 outcomes in paediatric cancer: A large scale pooled meta-analysis of 984 cancer patients. Rev Med Virol 2022; 32:e2344. [PMID: 35247015 PMCID: PMC9111056 DOI: 10.1002/rmv.2344] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 02/17/2022] [Accepted: 02/22/2022] [Indexed: 12/19/2022]
Abstract
We aimed to study the outcomes of COVID‐19 in paediatric cancer patients. On 26 October 2021, we did a systematic search for relevant articles in seven electronic databases followed by manual search. We included cancer patients aged ≤18 years. Event rates and the 95% confidence interval (95%CI) were used to report the results. We included 21 papers after screening of 2759 records. The pooled rates of hospitalisation, intensive care unit (ICU) admission and mortality were 44% (95%CI: 30–59), 14% (95%CI: 9–21) and 9% (95%CI: 6–12), respectively. Moreover, subgroup analysis revealed that high income countries had better COVID‐19 outcomes compared to upper middle income countries and lower middle income countries in terms of hospitalisation 30% (95%CI: 17–46), 60% (95%CI: 29–84) and 47% (95%CI: 36–58), ICU admission 7% (95%CI: 1–32), 13% (95%CI: 7–23) and 18% (95%CI: 6–41), and mortality 3% (95%CI: 2–5), 12% (95%CI: 8–18) and 13% (95%CI: 8–20), in order. In general, absence of specific pharmacologic intervention to prevent infection with the scarcity of vaccination coverage data among paediatric groups and its impact, high priority caution is required to avoid SARS‐CoV‐2 infection among paediatric cancer patients. Furthermore, our results highlight the importance of promoting care facilities for this vulnerable population in low and middle income regions to ensure quality care among cancer patients during pandemic crisis.
Collapse
Affiliation(s)
| | | | | | - Mohammad Rashidul Hashan
- Bangladesh Civil Service, Ministry of Health and Family Welfare, Dhaka, Bangladesh.,Central Queensland University, Rockhampton, QLD, Australia
| |
Collapse
|
27
|
Efendi D, Hasan F, Natalia R, Utami AR, Sonko I, Asmarini TA, Yuningsih R, Wanda D, Sari D. Nursing care recommendation for pediatric COVID-19 patients in the hospital setting: A brief scoping review. PLoS One 2022; 17:e0263267. [PMID: 35113925 PMCID: PMC8812980 DOI: 10.1371/journal.pone.0263267] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 01/14/2022] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The hospitalization of children during the COVID-19 pandemic has affected their physical and mental health. Pediatric nurses have faced challenges in providing high-quality nursing care for children and their families. However, the pediatric nursing care recommendations for COVID-19 patients in the hospital setting remain unclear. The current scoping review provides recommendations for nursing interventions for pediatric COVID-19 patients in the hospital setting. METHODS AND FINDINGS The selected articles containing management and nursing recommendations for COVID-19 that have occurred in pediatric patients ages 0-19 years old. A search strategy was developed and implemented in seven databases. We included peer-reviewed articles that reported observational or interventional studies, as well as policy papers, guides or guidelines, letters and editorials, and web articles. A total of 134 articles and other documents relevant to this review were included. We categorized the results based on The Nursing Intervention Classification (NIC) taxonomy which consists of six domains (e.g., Physiological: Basic); eleven classes (e.g., Nutrition Support); and eighteen intervention themes (e.g., Positioning, Family Presence Facilitation, Family Support, and Discharge Planning). CONCLUSION Apart from the intervention of physical problems, there is a need to promote patient- and family-centered care, play therapy, and discharge planning to help children and families cope with their new situation.
Collapse
Affiliation(s)
- Defi Efendi
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
- Neonatal Intensive Care Unit, Universitas Indonesia Hospital, Depok, Indonesia
| | - Faizul Hasan
- School of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Regina Natalia
- School of Nursing, Mitra Bunda Health Institute, Batam, Indonesia
| | - Ayuni Rizka Utami
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
| | - Ismaila Sonko
- School of Nursing, Taipei Medical University, Taipei, Taiwan
- Ministry of Health and Social Welfare, The Quadrangle, Banjul, The Gambia, West Africa
| | - Titik Ambar Asmarini
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
- Neonatal and Pediatric Intensive Care Unit, Gatot Soebroto Indonesian Central of Army Hospital, Jakarta, Indonesia
| | - Risna Yuningsih
- Neonatal Intensive Care Unit, Dr. Dradjat Prawiranegara General Hospital, Banten, Indonesia
| | - Dessie Wanda
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
| | - Dian Sari
- School of Nursing, Prima Nusantara Health Institute, Bukittinggi, Indonesia
| |
Collapse
|
28
|
McCarthy MC, Beamish J, Bauld CM, Marks IR, Williams T, Olsson CA, De Luca CR. Parent perceptions of pediatric oncology care during the COVID-19 pandemic: An Australian study. Pediatr Blood Cancer 2022; 69:e29400. [PMID: 34626447 PMCID: PMC8661975 DOI: 10.1002/pbc.29400] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 08/31/2021] [Accepted: 09/20/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND We examined parents' perceptions of their child's oncology care during a period of significant COVID-19 restrictions in Australia. METHODS Parents of children, 0-18 years, receiving hospital-based cancer treatment, completed a survey examining their COVID-19 exposure and impact, information and knowledge, and perception of their child's medical care. Recruitment occurred between October and November 2020. RESULTS Eighty-four parents (95% mothers) completed the survey. Sixty-seven percent of patients were diagnosed pre-COVID-19. The majority of parents (76%) reported negative impacts of COVID-19 on family life, including parenting and emotional well-being despite exposure to COVID-19 cases being very low (4%). Family functioning and parent birthplace were associated with COVID-19 impact and distress. Parents perceived the hospital as a safe place during the pandemic. Very few parents reported delaying presentation to the emergency department (12%). The majority identified no change (69%) or delay (71%) in their child's treatment delivery. Over 90% of parents were confident that COVID-19 did not impact medical decision-making. They felt confident in their COVID-19 knowledge and sought information from trusted sources. Parents reported a positive relationship with their child's care team (93%); however, access to some support services was reduced. CONCLUSION Understanding patient and family experiences of pediatric oncology care across international contexts during the pandemic is important to inform present and future health care responses. In the Australian context of low infection rates and strict community restrictions, parents perceived their child's oncology care to be relatively unaffected. However, findings indicate that family well-being was impacted, which warrants further investigation.
Collapse
Affiliation(s)
- Maria C. McCarthy
- Clinical SciencesMurdoch Children's Research InstituteMelbourneVictoriaAustralia,Children's Cancer CentreRoyal Children's HospitalParkvilleVictoriaAustralia,Department of PediatricsUniversity of MelbourneMelbourneVictoriaAustralia
| | - Jessica Beamish
- Clinical SciencesMurdoch Children's Research InstituteMelbourneVictoriaAustralia,Children's Cancer CentreRoyal Children's HospitalParkvilleVictoriaAustralia
| | - Catherine M. Bauld
- Department of PediatricsUniversity of MelbourneMelbourneVictoriaAustralia,Population HealthMurdoch Children's Research InstituteMelbourneVictoriaAustralia
| | - India R. Marks
- Clinical SciencesMurdoch Children's Research InstituteMelbourneVictoriaAustralia
| | - Tria Williams
- Infection & ImmunityMurdoch Children's Research InstituteMelbourneVictoriaAustralia
| | - Craig A. Olsson
- Department of PediatricsUniversity of MelbourneMelbourneVictoriaAustralia,Population HealthMurdoch Children's Research InstituteMelbourneVictoriaAustralia,Centre for Social and Early Emotional Development, School of Psychology, Faculty of HealthDeakin UniversityBurwoodVictoriaAustralia
| | - Cinzia R. De Luca
- Clinical SciencesMurdoch Children's Research InstituteMelbourneVictoriaAustralia,Children's Cancer CentreRoyal Children's HospitalParkvilleVictoriaAustralia
| |
Collapse
|
29
|
Baroni LV, Bouffet E. The impact of the COVID‐19 pandemic in pediatric oncology units: A lesson of resilience and hope. Cancer 2022; 128:1363-1364. [PMID: 35067918 PMCID: PMC9015345 DOI: 10.1002/cncr.34089] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 12/14/2021] [Indexed: 12/22/2022]
Abstract
The COVID‐19 pandemic in pediatric oncology units has had a major effect on health care providers globally. Although health care providers face the situation with resilience, the multiple consequences in terms of staff availability, psychological distress, and financial burden can potentially affect the care of children.
Collapse
Affiliation(s)
- Lorena V. Baroni
- Service of Hematology/Oncology Hospital J P Garrahan, Combate de los Pozos Buenos Aires Argentina
| | - Eric Bouffet
- Division of Haematology/Oncology The Hospital for Sick Children University of Toronto Toronto Ontario Canada
| |
Collapse
|
30
|
Kebudi R, Chantada G, Kurucu N, Tuğcu D, Mukkada S, C Moreira D. COVID-19: Consequences for Children With Cancer in Turkey and Globally. Turk Arch Pediatr 2022; 56:295-299. [PMID: 35005722 PMCID: PMC8655955 DOI: 10.5152/turkarchpediatr.2021.21134] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 05/04/2021] [Indexed: 12/11/2022]
Affiliation(s)
- Rejin Kebudi
- Department of Pediatric Hematology-Oncology, Institute of Oncology, Istanbul University, Istanbul, Turkey
| | - Guillermo Chantada
- Hemato-oncology Service, Hospital Pereira Rossell, Montevideo, Uruguay.,Hemato-oncology Service, Hospital Universitario Austral, Buenos Aires, Argentina.,Hospital Sant Joan de Deu, Hemato-oncology Service, Barcelona, Spain
| | - Nilgün Kurucu
- Department of Pediatric Oncology, Institute of Cancer, Hacettepe University School of Medicine, Ankara, Turkey
| | - Deniz Tuğcu
- Department of Pediatric Hematology-Oncology, Istanbul University School of Medicine,Istanbul,Turkey
| | - Sheena Mukkada
- Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Daniel C Moreira
- Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| |
Collapse
|
31
|
Castellar-López J, Villamizar-Villamizar W, Amaranto-Pallares A, Rosales-Rada W, De Los Angeles Vélez Verbel M, Chang A, Jiménez FT, Mendoza-Torres E. Recent Insights into COVID-19 in Children and Clinical Recommendations. Curr Pediatr Rev 2022; 18:121-137. [PMID: 34872479 DOI: 10.2174/1573396317666211206124347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 06/30/2021] [Accepted: 09/01/2021] [Indexed: 01/08/2023]
Abstract
Pediatric coronavirus disease 2019 (COVID-19) and multisystem inflammatory syndrome in children (MIS-C) have been recognized in multiple countries globally. In this review, we provide recent insights into SARS-CoV-2 infection in children from epidemiological, clinical, and laboratory perspectives, including reports on the disease course and therapy. We highlight key features of SARS-CoV-2 infection in children, the relationship between MIS-C and Kawasaki disease, and summarize treatment guidelines for COVID-19 in children from institutional protocols from Colombia, case reports, recommendations based on expert consensus, and official statements from organizations such as the World Health Organization (WHO), United States Center for Disease Control (CDC), Colombian Association of Infectious Diseases, and the Colombian Society of Pediatrics. Finally, we discuss gaps in research with suggestions for future research on the pathogenesis underlying pediatric COVID-19.
Collapse
Affiliation(s)
- Jairo Castellar-López
- Faculty of Exact and Natural Sciences, Grupo de Investigación Avanzada en Biomedicina, Universidad Libre Barranquilla, Barranquilla, Colombia
| | | | - Aldo Amaranto-Pallares
- Faculty of Health Sciences, Universidad Libre Seccional Barranquilla, Barranquilla, Colombia
| | - Wendy Rosales-Rada
- Faculty of Exact and Natural Sciences, Grupo de Investigación Avanzada en Biomedicina, Universidad Libre Barranquilla, Barranquilla, Colombia.,Department of Medicine, Grupo de Investigación en Biotecnología. Division of Health Sciences. Universidad del Norte, Colombia
| | | | - Aileen Chang
- Department of Medicine, George Washington University, Washington D.C., USA
| | - Franklin Torres Jiménez
- Faculty of Health Sciences, Universidad Libre Seccional Barranquilla, Barranquilla, Colombia
| | - Evelyn Mendoza-Torres
- Faculty of Health Sciences, Universidad Libre Seccional Barranquilla, Barranquilla, Colombia
| |
Collapse
|
32
|
Güney G, Önal G, Huri M. How Has the Occupational Performance and Participation Levels of Children with Cancer Changed during the COVID-19 Pandemic? Phys Occup Ther Pediatr 2022; 42:15-29. [PMID: 33947306 DOI: 10.1080/01942638.2021.1919814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Aim: To examine how the occupational performance (OP) and participation levels of children with cancer changed during the COVID-19 pandemic.Methods: Sixty-seven children with cancer (aged 6-12 years) completed the Canadian Occupational Performance Measure by giving information about their OP and participation, and their parents completed the Child and Adolescent Scale of Participation via online interview techniques. Evaluations were repeated twice in April and September 2020 to determine the change in OP and participation levels of children with cancer due to the COVID-19.Results: OP of children with cancer decreased significantly (Z=-7.02, p < 0.001) during the pandemic period. The home participation of these children did not change significantly (Z=-0.98, p = 0.32) before and during the pandemic; and was limited in both periods. Community participation decreased significantly (Z=-4.84, p < 0.001) from limited level to very limited level.Conclusions: Findings emphasize the need to increase the levels of OP and participation levels of children with various types of cancer due to the ramifications of the COVID-19 pandemic.
Collapse
Affiliation(s)
- Güleser Güney
- Therapy and Rehabilitation Department, Kütahya Sağlık Bilimleri University, Kütahya, Turkey
| | - Gözde Önal
- Therapy and Rehabilitation Department, Hacı Bektaş Veli University, Nevşehir, Turkey
| | | |
Collapse
|
33
|
Totadri S, Srinivasan HN, Joseph LL, Boddu D, Suresh Kochath P, Moorthy M, Mathew LG, John RR. The Unique Balancing Act of Managing Children With Cancer and COVID-19 Infection: A Single Center Experience From South India. J Pediatr Hematol Oncol 2022; 44:e287-e292. [PMID: 33769391 DOI: 10.1097/mph.0000000000002148] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 02/12/2021] [Indexed: 11/25/2022]
Abstract
Children with cancer are vulnerable to severe infections. Balancing the intensive treatment of cancer, with the potential risk of coronavirus disease-2019 (COVID-19) related morbidity and mortality is a unique challenge. Children with cancer testing positive for severe acute respiratory syndrome coronavirus 2 virus by reverse-transcription polymerase chain reaction at our center were studied. Thirty-seven children tested positive for COVID-19 during the study period. The severity of the illness was mild, moderate, severe, and critical in 10 (27%), 13 (35%), 12 (32%), and 2 (5%) patients, respectively. Of the 14 patients with a severe/critical illness, 2 had oncological emergencies, 4 had dengue co-infection, and 1 had an inguinal bacterial abscess. All patients were discharged in a stable condition. Modification of the treatment protocol was performed in 11 (33%) of 33 patients who were on active treatment for cancer. There was a median delay of 32.5 days to administer the next cycle of chemotherapy in patients who acquired COVID-19 during cancer treatment. Six of 7 patients who were retested after 14 days remained positive by reverse-transcription polymerase chain reaction. Children with cancer with COVID-19 recover with good supportive care. Curative chemotherapy can be administered safely with appropriate modifications in children with cancer with COVID-19.
Collapse
Affiliation(s)
| | | | - Leenu L Joseph
- Paediatric Haematology-Oncology Unit, Department of Paediatrics
| | - Deepthi Boddu
- Paediatric Haematology-Oncology Unit, Department of Paediatrics
| | | | - Mahesh Moorthy
- Clinical Virology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Leni G Mathew
- Paediatric Haematology-Oncology Unit, Department of Paediatrics
| | - Rikki R John
- Paediatric Haematology-Oncology Unit, Department of Paediatrics
| |
Collapse
|
34
|
Gattuso G, Schiavello E, Oltolini C, Biassoni V, Terenziani M, Chiaravalli S, Podda MG, Meazza C, Luksch R, Ferrari A, Casanova M, Sironi G, Bergamaschi L, Puma N, Spreafico F, Massimino M. Prolonged COVID-19 infection in a child with lymphoblastic non-Hodgkin lymphoma: which is the best management? TUMORI JOURNAL 2021; 108:NP1-NP4. [PMID: 34965799 DOI: 10.1177/03008916211067825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
During the coronavirus disease 2019 (COVID-19) pandemic, oncologists have managed patients at higher risk of having a severe course of this infection. This raises new questions about their correct management, as well as the difficulty of distinguishing tumor/treatments complications from those related to COVID-19. We report a case of an 11-year-old boy undergoing treatment for T-cell lymphoblastic lymphoma who experienced a prolonged COVID-19 course. Oncologic therapy was continued without significant changes compared to the initially planned treatment. No relevant complications occurred. COVID-19 convalescent plasma was administered, resulting in a positive antibody titer after 24 days.
Collapse
Affiliation(s)
- Giovanna Gattuso
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Elisabetta Schiavello
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Chiara Oltolini
- Clinic of Infectious Diseases, Division of Immunology, Transplantation and Infectious Diseases, San Raffaele Scientific Institute, Milan, Italy
| | - Veronica Biassoni
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Monica Terenziani
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Stefano Chiaravalli
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Marta Giorgia Podda
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Cristina Meazza
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Roberto Luksch
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Michela Casanova
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Giovanna Sironi
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Luca Bergamaschi
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Nadia Puma
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Filippo Spreafico
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Maura Massimino
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| |
Collapse
|
35
|
Davies J, O'Connor M, Halkett GKB, Kelada L, Gottardo NG. Parents' Experiences of Childhood Cancer During the COVID-19 Pandemic: An Australian Perspective. J Pediatr Psychol 2021; 47:148-157. [PMID: 34865100 PMCID: PMC8690259 DOI: 10.1093/jpepsy/jsab125] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 10/17/2021] [Accepted: 11/01/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction COVID-19 has had far-reaching impacts including changes in work, travel, social structures, education, and healthcare. Objective This study aimed to explore the experiences of parents of children receiving treatment for cancer during the COVID-19 pandemic. Methods Parents whose children were currently in treatment for childhood cancer or had completed treatment in the previous 12 months, participated in semi-structured interviews, face-to-face or via teleconferencing. Thematic analysis was used to analyze the data. Results The sample consisted of 34 participants (17 fathers and 17 mothers) from all states across Australia. Median age 37.5 years (range 29–51, years, SD = 6.3). Five main themes were identified: “Welcome to the Club”; “Remote Work and Study”; “Silver Linings”; “The Loneliest Experience” with three sub-themes “Immediate Family”; “Friends”; and “Overseas Family” and “Lack of Support” with two sub-themes: “Community Support” and “Organized Support.” Conclusion These findings revealed contrasting experiences of the impact of the COVID-19 pandemic. For parents whose children were neutropenic, the pandemic provided benefits in increased community understanding of infection control. Parents also reflected that the movement to remote work made it easier to earn an income. In contrast, some parents observed that restrictions on visitors and family intensified feelings of isolation. Parents also described how the COVID-19 reduced access to support services. These findings contribute to an understanding of the multifaceted impacts of the COVID-19 pandemic on families of children with cancer.
Collapse
Affiliation(s)
- Jenny Davies
- School of Population Health, Faculty of Health Sciences, Curtin University, Australia
| | - Moira O'Connor
- School of Population Health, Faculty of Health Sciences, Curtin University, Australia.,WA Cancer Prevention Research Unit, School of Population Health, Curtin University, Australia
| | - Georgia K B Halkett
- Faculty of Health Sciences, Curtin School of Nursing, Curtin University, Australia
| | - Lauren Kelada
- School of Women's and Children's Health, UNSW Sydney, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Australia
| | - Nicholas G Gottardo
- Brain Tumour Research Programme, Telethon Kids Institute, Australia.,Paediatrics, School of Medicine, University of Western Australia, Australia.,Department of Paediatric and Adolescent Oncology/Haematology, Perth Children's Hospital, Australia
| |
Collapse
|
36
|
Haeusler GM, Ammann RA, Carlesse F, Groll AH, Averbuch D, Castagnola E, Agyeman PK, Phillips B, Gilli F, Solopova G, Attarbaschi A, Wegehaupt O, Speckmann C, Sung L, Lehrnbecher T. SARS-CoV-2 in children with cancer or after haematopoietic stem cell transplant: An analysis of 131 patients. Eur J Cancer 2021; 159:78-86. [PMID: 34736044 PMCID: PMC8501219 DOI: 10.1016/j.ejca.2021.09.027] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 09/15/2021] [Accepted: 09/22/2021] [Indexed: 12/14/2022]
Abstract
PURPOSE There are limited data on SARS-CoV-2 (COVID-19) infection in children with cancer or after haematopoietic stem cell transplant (HSCT). We describe the severity and outcomes of SARS-COV-2 in these patients and identify factors associated with severe disease. METHODS This was a multinational, observational study of children (aged <19 years) with cancer or HSCT and SARS-CoV-2 confirmed by polymerase chain reaction. COVID-19 was classified as asymptomatic, mild, moderate, severe or critical (≥1 organ support). Exact polytomous regression was used to determine the relationship between clinical variables and disease severity. RESULTS One hundred and thirty-one patients with COVID-19 across 10 countries were identified (median age 8 years). Seventy-eight (60%) had leukaemia/lymphoma, 48 (37%) had solid tumour and five had primary immunodeficiency and HSCT. Fever (71%), cough (47%) and coryza (29%) were the most frequent symptoms. The median duration of detectable virus was 16 days (range, 1-79 days). Forty-nine patients (37%) were hospitalised for COVID-19 symptoms, and 15 (11%) required intensive care unit-level care. Chemotherapy was delayed/modified in 35% of patients. COVID-19 was asymptomatic in 32% of patients, mild in 47%, moderate in 8%, severe in 4% and critical in 9%. In 124 patients (95%), a full recovery was documented, and four (3%) died due to COVID-19. Any comorbidity (odds ratio, 2.94; 95% confidence interval [CI], 1.81-5.21), any coinfection (1.74; 95% CI 1.03-3.03) and severe baseline neutropenia (1.82; 95% CI 1.13-3.09) were independently and significantly associated with increasing disease severity. CONCLUSION Although most children with cancer had asymptomatic/mild disease, 13% had severe COVID-19 and 3% died. Comorbidity, coinfection and neutropenia may increase the risk of severe disease. Our data may help management decisions in this vulnerable population.
Collapse
Affiliation(s)
- Gabrielle M. Haeusler
- Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia,NHMRC National Centre for Infections in Cancer, Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia,The Paediatric Integrated Cancer Service, Parkville, Victoria State Government, Australia,Infection Diseases Unit, Department of General Medicine, Royal Children's Hospital, Parkville, Victoria, Australia,Infection and Immunity Theme, Murdoch Children's Research Institute, Parkville, Australia,Corresponding author: Murdoch Children's Research Institute, Flemington Rd, Parkville, Australia
| | - Roland A. Ammann
- Paediatric Hematology and Oncology, Department of Paediatrics, Inselspital, Bern University Hospital, Bern, Switzerland,Kinderaerzte KurWerk, Burgdorf, Switzerland
| | - Fabianne Carlesse
- Paediatric Oncology Institute, GRAACC/Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Andreas H. Groll
- Infectious Disease Research Program, Center for Bone Marrow Transplantation, Department of Paediatric Hematology and Oncology, University Children's Hospital Münster, Münster, Germany
| | - Dina Averbuch
- Paediatric Infectious Disease, Faculty of Medicine, Hebrew University of Jerusalem, Hadassah Medical Center, Jerusalem, Israel
| | - Elio Castagnola
- Infectious Diseases Unit, Department of Paediatrics, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Philipp K.A. Agyeman
- Paediatric Hematology and Oncology, Department of Paediatrics, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Bob Phillips
- Leeds Cancer Centre, Leeds Teaching Hospital, NHS Trust, Leeds, United Kingdom,Centre for Reviews and Dissemination, University of York, York, United Kingdom
| | - Flávio Gilli
- Department of Paediatric Intensive Care, Centro Infantil Boldrini, Campinas, Brazil
| | - Galina Solopova
- Dmitry Rogachev Federal Scientific-Clinical Center of Children's Hematology, Oncology and Immunology, Moscow, Russia
| | - Andishe Attarbaschi
- Paediatric Hematology and Oncology, St. Anna Children's Hospital, Medical University of Vienna, Vienna, Austria
| | - Oliver Wegehaupt
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency, Faculty of Medicine, University of Freiburg, Freiburg, Germany,Center for Paediatrics and Adolescent Medicine, Department of Paediatric Hematology and Oncology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Carsten Speckmann
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency, Faculty of Medicine, University of Freiburg, Freiburg, Germany,Center for Paediatrics and Adolescent Medicine, Department of Paediatric Hematology and Oncology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Lillian Sung
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Thomas Lehrnbecher
- Paediatric Hematology and Oncology, Hospital for Children and Adolescents, Johann Wolfgang Goethe University, Frankfurt, Germany
| |
Collapse
|
37
|
Corso MCM, Soares VJ, Amorim AMP, Cipolotti R, Magalhães IMQ, Lins MM, Forsait S, Silva LN, de Sousa AVL, Alves NG, do Prado SI, Silva KAS, Carbone EK, Brumatti M, Santiago P, Pereira KMM, Carlesse FA, Aguiar MG, Marques RF, Rechenmacher C, Daudt LE, Michalowski MB. SARS-CoV-2 in children with cancer in Brazil: Results of a multicenter national registry. Pediatr Blood Cancer 2021; 68:e29223. [PMID: 34288386 PMCID: PMC8441618 DOI: 10.1002/pbc.29223] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 05/28/2021] [Accepted: 06/21/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Strategies to mitigate the impact of COVID-19 in special populations are complex and challenging. Few studies have addressed the impact of COVID-19 on pediatric patients with cancer in low- and middle-income countries. METHODS Multicenter observational cohort study with prospective records and retrospective analyses starting in April 2020 in 21 pediatric oncology centers distributed throughout Brazil. PARTICIPANTS Patients under 18 years of age who are infected by the SARS-CoV-2 virus (confirmed diagnosis through reverse transcriptase-polymerase chain reaction [RT-PCR]) while under treatment at pediatric oncology centers. The variables of interest included clinical symptoms, diagnostic and therapeutic measures. The repercussions of SARS-CoV-2 infection on cancer treatment and general prognosis were monitored. RESULTS One hundred seventy-nine patients were included (median age 6 [4-13] years, 58% male). Of these, 55.9% had acute leukemia and 34.1% had solid tumors. The presence of SARS-CoV-2 was diagnosed by RT-PCR. Various laboratory markers were analyzed, but showed no correlation with outcome. Children with low or high BMI for age had lower overall survival (71.4% and 82.6%, respectively) than those with age-appropriate BMI (92.7%) (p = .007). The severity of presentation at diagnosis was significantly associated with outcome (p < .001). Overall mortality in the presence of infection was 12.3% (n = 22). CONCLUSION In children with cancer and COVID-19, lower BMI was associated with worse prognosis. The mortality in this group of patients (12.3%) was significantly higher than that described in the pediatric population overall (∼1%).
Collapse
Affiliation(s)
| | - Victor J. Soares
- Faculdade de MedicinaUniversidade Federal do Rio Grande do SulPorto AlegreBrazil
| | | | - Rosana Cipolotti
- Universidade Federal de SergipeSão CristóvãoBrazil,Centro de Oncologia de Sergipe Dr. Oswaldo LeiteAracajuBrazil
| | | | - Mecneide M. Lins
- Instituto de Medicina Integral Professor Fernando FigueiraRecifeBrazil
| | - Silvana Forsait
- Instituto de Tratamento do Câncer Infantil ‐ ITACISão PauloBrazil
| | | | | | | | | | | | | | | | - Pablo Santiago
- Associação Hospitalar Beneficente São Vicente de PauloPasso FundoBrazil
| | | | | | | | - Rebeca F. Marques
- Laboratório de Pediatria TranslacionalServiço de Pesquisa Experimental, Hospital de Clínicas de Porto AlegrePorto AlegreBrazil
| | - Ciliana Rechenmacher
- Departamento de PediatriaUniversidade Federal do Rio Grande do SulPorto AlegreBrazil,Laboratório de Pediatria TranslacionalServiço de Pesquisa Experimental, Hospital de Clínicas de Porto AlegrePorto AlegreBrazil
| | - Liane E. Daudt
- Departamento de PediatriaUniversidade Federal do Rio Grande do SulPorto AlegreBrazil,Laboratório de Pediatria TranslacionalServiço de Pesquisa Experimental, Hospital de Clínicas de Porto AlegrePorto AlegreBrazil,Unidade de Hematologia e Transplante de Medula Óssea Pediátrica, Serviço de Hematologia ClínicaHospital de Clínicas de Porto AlegrePorto AlegreBrazil
| | - Mariana B. Michalowski
- Departamento de PediatriaUniversidade Federal do Rio Grande do SulPorto AlegreBrazil,Laboratório de Pediatria TranslacionalServiço de Pesquisa Experimental, Hospital de Clínicas de Porto AlegrePorto AlegreBrazil,Serviço de Oncologia PediátricaHospital de Clínicas de Porto AlegrePorto AlegreBrazil
| |
Collapse
|
38
|
Kamdar KY, Kim TO, Doherty EE, Pfeiffer TM, Qasim SL, Suell MN, Yates AM, Blaney SM. COVID-19 outcomes in a large pediatric hematology-oncology center in Houston, Texas. Pediatr Hematol Oncol 2021; 38:695-706. [PMID: 34032552 DOI: 10.1080/08880018.2021.1924327] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
An understanding of the behavior of SARS-CoV-2 in pediatric hematology-oncology patients is essential to the optimal management of these patients during the COVID-19 pandemic. This study describes the characteristics and outcomes of COVID-19 disease in children with cancer or hematologic disorders treated at a large children's hospital. A retrospective cohort study was conducted at Texas Children's Cancer and Hematology Center from January 1, 2020 to September 30, 2020. All patients with a primary hematology-oncology diagnosis and SARS-CoV-2 positivity by reverse transcription polymerase chain reaction were identified. Clinical and laboratory data were obtained from the medical record. Descriptive analyses were performed to evaluate COVID-19-related outcomes and risk factors for severe disease in this population. We identified 109 patients with COVID-19 disease, including 52 hematology, 51 oncology, and 6 HSCT patients; median age was 10.3 years (IQR 4.4-15.9), and 58.7% were male. Seventy-four percent of the patients were managed in the outpatient setting. Patients with sickle cell disease were more likely to require hospitalization. ICU care was needed in 8% (n = 9) of the entire cohort, and mechanical ventilation was required in 6.4% (6 oncology patients, 1 hematology patient). COVID-19 contributed to the deaths of two cancer patients. No deaths occurred in hematology or HSCT patients. In conclusion, the risk of severe COVID-19 complications is slightly higher in pediatric hematology-oncology patients than in the general pediatric population but lower than initially feared. For most asymptomatic patients, primary disease management may continue as planned, but treatment decisions must be individualized.
Collapse
Affiliation(s)
- Kala Y Kamdar
- Texas Children's Cancer and Hematology Center and Baylor College of Medicine, Department of Pediatrics, Section of Hematology-Oncology, Houston, Texas, USA
| | - Taylor O Kim
- Texas Children's Cancer and Hematology Center and Baylor College of Medicine, Department of Pediatrics, Section of Hematology-Oncology, Houston, Texas, USA
| | - Erin E Doherty
- Texas Children's Cancer and Hematology Center and Baylor College of Medicine, Department of Pediatrics, Section of Hematology-Oncology, Houston, Texas, USA
| | - Thomas M Pfeiffer
- Texas Children's Cancer and Hematology Center and Baylor College of Medicine, Department of Pediatrics, Section of Hematology-Oncology, Houston, Texas, USA
| | - Shawki L Qasim
- Texas Children's Cancer and Hematology Center and Baylor College of Medicine, Department of Pediatrics, Section of Hematology-Oncology, Houston, Texas, USA
| | - Mary Nell Suell
- Texas Children's Cancer and Hematology Center and Baylor College of Medicine, Department of Pediatrics, Section of Hematology-Oncology, Houston, Texas, USA
| | - Amber M Yates
- Texas Children's Cancer and Hematology Center and Baylor College of Medicine, Department of Pediatrics, Section of Hematology-Oncology, Houston, Texas, USA
| | - Susan M Blaney
- Texas Children's Cancer and Hematology Center and Baylor College of Medicine, Department of Pediatrics, Section of Hematology-Oncology, Houston, Texas, USA
| |
Collapse
|
39
|
Węcławek-Tompol J, Zakrzewska Z, Gryniewicz-Kwiatkowska O, Pierlejewski F, Bień E, Zaucha-Prażmo A, Zając-Spychała O, Szmydki-Baran A, Mizia-Malarz A, Bal W, Sawicka-Żukowska M, Kruk A, Raciborska A, Książek A, Szczepański T, Peregud-Pogorzelski J, Krawczuk-Rybak M, Chaber R, Matysiak M, Wachowiak J, Młynarski W, Dembowska-Bagińska B, Balwierz W, Matkowska-Kocjan A, Kazanowska B, Styczyński J, Ussowicz M. COVID-19 in pediatric cancer patients is associated with treatment interruptions but not with short-term mortality: a Polish national study. J Hematol Oncol 2021; 14:163. [PMID: 34635137 PMCID: PMC8503711 DOI: 10.1186/s13045-021-01181-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 09/29/2021] [Indexed: 12/23/2022] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) currently constitutes the leading and overwhelming health issue worldwide. In comparison with adults, children present milder symptoms, with most having an asymptomatic course. We hypothesized that COVID-19 infection has a negative impact on the continuation of chemotherapy and increases nonrelapse mortality. Material and methods This study was performed to assess the course of SARS-CoV-2 among children with hematological or oncological malignancies and its impact on cancer therapy. Records of SARS-CoV-2 infection in 155 children with malignancies from 14 Polish centers for pediatric hematology and oncology were collected and analyzed. Results SARS-CoV-2 replication was observed in 155 patients. Forty-nine patients were symptomatic, with the following being the most common manifestations: fever (31 patients), gastrointestinal symptoms (10), coryza (13), cough (13) and headache (8). In children who were retested, the median time of a positive PCR result was 16 days (range 1–70 days), but 12.7% of patients were positive beyond day + 20. The length of viral PCR positivity correlated with the absolute neutrophil count at diagnosis. Seventy-six patients did not undergo further SARS-CoV-2 testing and were considered convalescents after completion of isolation. Antibiotic therapy was administered in 15 children, remdesivir in 6, convalescent plasma in 4, oxygen therapy in 3 (1—mechanical ventilation), steroids in 2, intravenous immunoglobulins in 2, and heparin in 4. Eighty patients were treated with chemotherapy within 30 days after SARS-CoV-2 infection diagnosis or were diagnosed with SARS-CoV-2 infection during 30 days of chemotherapy administration. Respiratory symptoms associated with COVID-19 and associated with oxygen therapy were present in 4 patients in the study population, and four deaths were recorded (2 due to COVID-19 and 2 due to progressive malignancy). The probability of 100-day overall survival was 97.3% (95% CI 92.9–99%). Delay in the next chemotherapy cycle occurred in 91 of 156 cases, with a median of 14 days (range 2–105 days). Conclusions For the majority of pediatric cancer patients, SARS-CoV-2 infection does not result in a severe, life-threatening course. Our data show that interruptions in therapy are common and can result in suboptimal therapy. Supplementary Information The online version contains supplementary material available at 10.1186/s13045-021-01181-4.
Collapse
Affiliation(s)
- Jadwiga Węcławek-Tompol
- Department and Clinic of Pediatric Oncology, Haematology and Bone Marrow Transplantation, Wroclaw Medical University, Borowska 213, 50-556, Wroclaw, Poland
| | - Zuzanna Zakrzewska
- Department of Pediatric Oncology and Hematology, Institute of Pediatrics, Jagiellonian University, Collegium Medicum, Kraków, Poland
| | | | - Filip Pierlejewski
- Department of Pediatrics, Hematology and Oncology, Medical University of Lodz, Lodz, Poland
| | - Ewa Bień
- Department of Pediatrics, Hematology and Oncology, Medical University of Gdansk, Gdansk, Poland
| | - Agnieszka Zaucha-Prażmo
- Department of Pediatric Hematology, Oncology and Transplantology, Medical University of Lublin, Lublin, Poland
| | - Olga Zając-Spychała
- Department of Pediatric Oncology, Hematology and Transplantology, University of Medical Sciences, Poznan, Poland
| | - Anna Szmydki-Baran
- Department of Oncology, Pediatric Hematology, Transplantology and Pediatrics, Children's Hospital, Medical University of Warsaw, Warsaw, Poland
| | | | - Wioletta Bal
- Clinic of Pediatric Oncology and Hematology, State Hospital 2 in Rzeszow, Rzeszow, Poland.,Department of Paediatrics, Institute of Medical Sciences, University of Rzeszow, Rzeszow, Poland
| | | | - Agnieszka Kruk
- Department of Paediatrics, Paediatric Oncology and Immunology, Pomeranian Medical University, Szczecin, Poland
| | - Anna Raciborska
- Department of Oncology and Surgical Oncology for Children and Youth, Institute of Mother and Child, Warsaw, Poland
| | - Agnieszka Książek
- Department of Pediatric Hematology and Oncology, Zabrze, Medical University of Silesia, Katowice, Poland
| | - Tomasz Szczepański
- Department of Pediatric Hematology and Oncology, Zabrze, Medical University of Silesia, Katowice, Poland
| | | | - Maryna Krawczuk-Rybak
- Department of Pediatric Oncology and Hematology, Medical University of Bialystok, Białystok, Poland
| | - Radosław Chaber
- Clinic of Pediatric Oncology and Hematology, State Hospital 2 in Rzeszow, Rzeszow, Poland.,Department of Paediatrics, Institute of Medical Sciences, University of Rzeszow, Rzeszow, Poland
| | - Michał Matysiak
- Department of Oncology, Pediatric Hematology, Transplantology and Pediatrics, Children's Hospital, Medical University of Warsaw, Warsaw, Poland
| | - Jacek Wachowiak
- Department of Pediatric Oncology, Hematology and Transplantology, University of Medical Sciences, Poznan, Poland
| | - Wojciech Młynarski
- Department of Pediatrics, Hematology and Oncology, Medical University of Lodz, Lodz, Poland
| | | | - Walentyna Balwierz
- Department of Pediatric Oncology and Hematology, Institute of Pediatrics, Jagiellonian University, Collegium Medicum, Kraków, Poland
| | | | - Bernarda Kazanowska
- Department and Clinic of Pediatric Oncology, Haematology and Bone Marrow Transplantation, Wroclaw Medical University, Borowska 213, 50-556, Wroclaw, Poland
| | - Jan Styczyński
- Department of Pediatric Hematology and Oncology, Jurasz University Hospital, Collegium Medicum Nicolaus Copernicus University Torun, Bydgoszcz, Poland
| | - Marek Ussowicz
- Department and Clinic of Pediatric Oncology, Haematology and Bone Marrow Transplantation, Wroclaw Medical University, Borowska 213, 50-556, Wroclaw, Poland.
| |
Collapse
|
40
|
Moreira DC. The impact of the COVID-19 pandemic on pediatric cancer care. Cancer 2021; 128:456-457. [PMID: 34618351 PMCID: PMC8653076 DOI: 10.1002/cncr.33946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/08/2021] [Accepted: 09/10/2021] [Indexed: 11/21/2022]
Abstract
This editorial contextualizes the work by Sharma et al on the effects of the COVID‐19 pandemic on pediatric cancer care in India.
Collapse
|
41
|
Revon-Riviere G, Soler C, Andrianarivony T, Fily S, André N. Favorable Outcome of COVID-19 Infection in a Pediatric Cancer Patient Receiving an Anti-PD-L1/Anti-CTLA-4 Combination. J Pediatr Hematol Oncol 2021; 43:e1045-e1046. [PMID: 33625085 DOI: 10.1097/mph.0000000000002099] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Gabriel Revon-Riviere
- Department of Pediatric Oncology & Hematology
- Marseille Early Phases Cancer Trials Center CLIP², Aix Marseille University APHM, Marseille
| | - Christine Soler
- Hematology Department, Hôpital l'Archet CHU de Nice, Nice, France
| | | | - Sarah Fily
- Department of Pediatric Oncology & Hematology
| | - Nicolas André
- Department of Pediatric Oncology & Hematology
- Marseille Early Phases Cancer Trials Center CLIP², Aix Marseille University APHM, Marseille
| |
Collapse
|
42
|
Bansal R, Aishwarya A, Rao R, Christy MC, Sen M, Regani H, Bagai P, Reddy VA, Mulay K, Bongoni P, Honavar SG. Impact of COVID-19 nationwide lockdown on retinoblastoma treatment and outcome: A study of 476 eyes of 326 children. Indian J Ophthalmol 2021; 69:2617-2624. [PMID: 34571599 PMCID: PMC8597487 DOI: 10.4103/ijo.ijo_2243_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Purpose The novel coronavirus SARS-CoV-2 (COVID-19) and the resultant nationwide lockdown and travel restrictions led to difficulty in providing timely and regular treatment to patients with childhood cancers such as retinoblastoma. This study is aimed at assessing the demography, clinical presentation, treatment strategies, and outcome of treatment defaulters due to the lockdown. Methods Cross-sectional, observational study of retinoblastoma patients at a tertiary care ocular oncology center during the first wave of COVID-19 and the resulting nationwide lockdown. Results Of the 476 eyes of 326 patients undergoing active management with a median age of 57 months (range: 4-214 months), 205 (63%) patients returned for follow-up after a mean delay of 45.8 ± 24.3 weeks (range: 8-80 weeks) and 121 (37%) were defaulters according to the data analyzed till June 30, 2021. Distance of residence was ≥1000 km for 148 patients (46%). In terms of need for active treatment, the number of emergent cases was 2 (<1%), 11 (3%) were urgent, and 313 (96%) were semi-urgent. International classification groups D (n = 107 eyes, 23%) and E (n = 173 eyes, 36%) were in majority, and 13 eyes (4%) and 4 eyes (1%) were at stages 3 and 4, respectively. Prior to lockdown, 86 eyes (18%) had active tumor, which remained unchanged (n = 26, 30%) or worsened (n = 49, 60%) after failure to follow-up. Vision (47%), eye (92%), and life salvage (98%) were achieved by individualized protocol-based management after the patients returned for further management. Five children succumbed to intracranial extension. Conclusion The COVID-19-related nationwide lockdown has deprived retinoblastoma patients of optimal and timely management, leading to prolonged treatment interruptions, delays, permanent default, and death. It is of paramount importance for all the stakeholders to increase awareness, make necessary travel and logistic arrangements, and ensure continuity of care for children with retinoblastoma.
Collapse
Affiliation(s)
| | | | - Raksha Rao
- Narayana Nethralaya, Bangalore, Karnataka, India
| | | | | | | | | | | | | | | | | |
Collapse
|
43
|
Vila R, Vázquez-Gómez F, Fioravantti V, García-Fernandez M, Lassaletta A. How a pediatric neuro-oncology unit was managed in Madrid during the first wave of the COVID-19 pandemic. TUMORI JOURNAL 2021; 108:552-555. [PMID: 34550029 DOI: 10.1177/03008916211048234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION During the first wave of the coronavirus disease 2019 (COVID-19) pandemic, infection prevention measures were enforced at our Pediatric Neuro-Oncology unit. METHODS A retrospective study analyzing patients booked in this unit during lockdown was performed to describe its performance. RESULTS There were 438 consultations for 123 patients (320 on-site/118 telephone). Eight new diagnoses were made, with one significant delay. Only one patient tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Delay in imaging testing occurred in 15 patients. Chemotherapy was delayed in one case. There were no delays in radiotherapy. CONCLUSIONS Measures implemented were effective in minimizing the risk of COVID-19 infection, achieving continuity in diagnoses and treatment, and avoiding delays that could impact survival.
Collapse
Affiliation(s)
- Rocio Vila
- Pediatric Neuro-Oncology Unit, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Felisa Vázquez-Gómez
- Pediatric Neuro-Oncology Unit, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Victoria Fioravantti
- Pediatric Neuro-Oncology Unit, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | | | - Alvaro Lassaletta
- Pediatric Neuro-Oncology Unit, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| |
Collapse
|
44
|
Qureshi SS, Ramraj D, Chinnaswamy G, Parambil BC, Prasad M, Amin N, Ramanathan S, Khanna N, Laskar S. Assessment of outcomes of elective cancer surgeries in children during coronavirus disease 2019 pandemic: Retrospective cohort study from a tertiary cancer center in India. Medicine (Baltimore) 2021; 100:e26752. [PMID: 34477115 PMCID: PMC8415926 DOI: 10.1097/md.0000000000026752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 07/08/2021] [Indexed: 01/05/2023] Open
Abstract
To describe the outcomes of elective cancer surgeries and adverse consequences on the patients and medical staff due to the surgical interventions in children during the Coronavirus Disease 2019 (COVID-19) pandemic.The study included children younger than 15 years who underwent elective cancer surgeries from March 4, 2020 and December 3, 2020.A total of 121 patients (62% male; median age, 3 years) underwent surgery. The surgical procedures included nephrectomies (n = 18), neuroblastoma (n = 26) and soft tissue tumor resections (n = 24) and complex surgical procedures like extended liver resections (n = 2), intra-atrial thrombectomy under cardiopulmonary bypass (n = 2), pancreatoduodenectomy (n = 1), and free microvascular flaps (n = 7). Clavien-Dindo Grade III complications were 5% (n = 6), and there were no postoperative deaths. Preoperative COVID-19 testing was performed in 82% of children, and only 2% showed severe acute respiratory syndrome coronavirus 2 positivity. Postoperatively, 26 children were tested because of specific symptoms and, 6 tested positive for severe acute respiratory syndrome coronavirus 2. Except for a median delay of 23 days in treatment, none of the patients with COVID-19 required critical hospital management. None of the surgical residents or faculty acquired COVID-19, while 4 each medical and support staff were tested positive in the study period.COVID-19 was not a deterrent for continued cancer care, and surgeries could be safely performed adopting universal preventive measures without any added morbidity from COVID-19. Caregivers and centers dealing with childhood cancers can be encouraged to sustain or seek early healthcare.
Collapse
Affiliation(s)
- Sajid S. Qureshi
- Division of Paediatric Surgical Oncology, Department of Surgical Oncology, Tata Memorial Hospital and Advanced Centre for Training Research and Education in Cancer (ACTREC), Tata Memorial Centre, Mumbai, India
- Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Deepak Ramraj
- Division of Paediatric Surgical Oncology, Department of Surgical Oncology, Tata Memorial Hospital and Advanced Centre for Training Research and Education in Cancer (ACTREC), Tata Memorial Centre, Mumbai, India
| | - Girish Chinnaswamy
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Division of Pediatric Oncology, Department of Medical Oncology, Tata Memorial Hospital and Advanced Centre for Training Research and Education in Cancer (ACTREC), Tata Memorial Centre, Mumbai, India
| | - Badira C. Parambil
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Division of Pediatric Oncology, Department of Medical Oncology, Tata Memorial Hospital and Advanced Centre for Training Research and Education in Cancer (ACTREC), Tata Memorial Centre, Mumbai, India
| | - Maya Prasad
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Division of Pediatric Oncology, Department of Medical Oncology, Tata Memorial Hospital and Advanced Centre for Training Research and Education in Cancer (ACTREC), Tata Memorial Centre, Mumbai, India
| | - Nayana Amin
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Anaesthesia, Tata Memorial Hospital, and Advanced Centre for Training Research and Education in Cancer (ACTREC), Tata Memorial Centre, Mumbai, India
| | - Subramaniam Ramanathan
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Division of Pediatric Oncology, Department of Medical Oncology, Tata Memorial Hospital and Advanced Centre for Training Research and Education in Cancer (ACTREC), Tata Memorial Centre, Mumbai, India
| | - Nehal Khanna
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Radiation Oncology, Tata Memorial Hospital and Advanced Centre for Training Research and Education in Cancer (ACTREC), Tata Memorial Centre, Mumbai, India
| | - Siddharth Laskar
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Radiation Oncology, Tata Memorial Hospital and Advanced Centre for Training Research and Education in Cancer (ACTREC), Tata Memorial Centre, Mumbai, India
| |
Collapse
|
45
|
Ebach F, Hainmann I, Eis‐Hübinger AM, Escherisch G, Dilloo D, Reutter HM, Müller A. Successful ECMO therapy in a child with COVID-19-associated ARDS and acute lymphoblastic leukemia. Pediatr Blood Cancer 2021; 68:e29100. [PMID: 34022118 PMCID: PMC8209893 DOI: 10.1002/pbc.29100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/22/2021] [Accepted: 04/23/2021] [Indexed: 12/05/2022]
Affiliation(s)
- Fabian Ebach
- Department of Neonatology and Pediatric Intensive Care, Children's HospitalUniversity of BonnBonnGermany
| | - Ina Hainmann
- Department of Pediatric Hematology and Oncology, Children's HospitalUniversity of BonnBonnGermany
| | | | - Gabriele Escherisch
- Clinic of Paediatric Haematology and OncologyUniversity Medical Centre Hamburg‐EppendorfHamburgGermany
| | - Dagmar Dilloo
- Department of Pediatric Hematology and Oncology, Children's HospitalUniversity of BonnBonnGermany
| | - Heiko M. Reutter
- Department of Neonatology and Pediatric Intensive Care, Children's HospitalUniversity of BonnBonnGermany
| | - Andreas Müller
- Department of Neonatology and Pediatric Intensive Care, Children's HospitalUniversity of BonnBonnGermany
| |
Collapse
|
46
|
Silva-Rodrigues FM, Silva JKD, Felix AMDS. Coronavirus infection and nursing care for children and adolescents with cancer. Rev Bras Enferm 2021; 74Suppl 1:e20201049. [PMID: 34259723 DOI: 10.1590/0034-7167-2020-1049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 04/02/2021] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE Reflect on the implications of COVID-19 for the nursing care of pediatric oncology patients. METHODS Theoretical and reflective essay, based on recent scientific publications and expert recommendations on the care of pediatric patients under cancer treatment in the context of the current pandemic. RESULTS Reflected on the involvement of the pediatric population in general by COVID-19, the vulnerability of pediatric oncology patients to the complications of the disease and the likely challenges for their care. The pandemic demanded a rapid adaptation of health services in terms of patient care flow, care protocols, infection prevention measures, and redefinition of cancer therapy, with repercussions for professionals, patients, and their families. FINAL CONSIDERATIONS It is not yet known how often or how severely children with cancer have been affected by COVID-19, but therapeutic and care adaptations for the maintenance of these patients' treatment in the pandemic context are noted.
Collapse
Affiliation(s)
| | - Jennifer Kamila da Silva
- Instituto de Oncologia Pediátrica, Grupo de Assistência ao Adolescente e à Criança com Câncer. São Paulo, São Paulo, Brazil
| | | |
Collapse
|
47
|
Meryk A, Kropshofer G, Hetzer B, Riedl D, Lehmann J, Rumpold G, Haid A, Holzner B, Crazzolara R. Bridging the gap in outpatient care: Can a daily patient-reported outcome measure help? Cancer Rep (Hoboken) 2021; 5:e1421. [PMID: 34245127 PMCID: PMC8789604 DOI: 10.1002/cnr2.1421] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 04/29/2021] [Accepted: 05/03/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Childhood patients have high risks for developing debilitating somatic and mental health side-effects as a consequence of the many different approaches employed in treating their cancer. Early recognition and close monitoring of clinical and psychological problems are essential in planning appropriate interventions and preventing further deterioration. CASE ePROtect was established as an easy-to-use application for daily self-reporting of symptoms during cancer therapy. ePROtect includes six to eight questions pertaining to seven common symptoms: appetite loss, fatigue, nausea, pain, physical functioning, cognitive impairments and sleep quality. The case of a child diagnosed with Burkitt leukemia developing chemotherapy-induced oral mucositis in home care is presented to show the therapeutic impact of early symptom detection with a daily web-based tool. CONCLUSION This case highlights how electronic patient-reported outcome measures (PROM) can directly facilitate patient care in real time and might be incorporated in future clinical routine.
Collapse
Affiliation(s)
- Andreas Meryk
- Department of Pediatrics, Medical University of Innsbruck, Innsbruck, Austria
| | - Gabriele Kropshofer
- Department of Pediatrics, Medical University of Innsbruck, Innsbruck, Austria
| | - Benjamin Hetzer
- Department of Pediatrics, Medical University of Innsbruck, Innsbruck, Austria
| | - David Riedl
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Medical Psychology, Medical University of Innsbruck, Innsbruck, Austria
| | - Jens Lehmann
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria
| | - Gerhard Rumpold
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Medical Psychology, Medical University of Innsbruck, Innsbruck, Austria
| | - Alexandra Haid
- Department of Pediatrics, Medical University of Innsbruck, Innsbruck, Austria
| | - Bernhard Holzner
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria
| | - Roman Crazzolara
- Department of Pediatrics, Medical University of Innsbruck, Innsbruck, Austria
| |
Collapse
|
48
|
Sharathkumar AA, Faustino EVS, Takemoto CM. How we approach thrombosis risk in children with COVID-19 infection and MIS-C. Pediatr Blood Cancer 2021; 68:e29049. [PMID: 33955167 PMCID: PMC8206673 DOI: 10.1002/pbc.29049] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 03/04/2021] [Accepted: 03/22/2021] [Indexed: 01/08/2023]
Abstract
Thrombosis within the microvasculature and medium to large vessels is a serious and common complication among critically ill individuals with coronavirus disease 2019 (COVID-19). While children are markedly less likely to develop severe disease than adults, they remain at risk for thrombosis during acute infection and with the post-acute inflammatory illness termed multisystem inflammatory syndrome in children. Significant knowledge deficits in understanding COVID-19-associated coagulopathy and thrombotic risk pose clinical challenges for pediatric providers who must incorporate expert opinion and personal experience to manage individual patients. We discuss clinical scenarios to provide framework for characterizing thrombosis risk and thromboprophylaxis in children with COVID-19.
Collapse
Affiliation(s)
- Anjali A. Sharathkumar
- Stead Family Department of Pediatrics, Carver College of MedicineUniversity of IowaIowa CityIowaUSA
| | - E. Vincent S. Faustino
- Section of Pediatric Critical Care Medicine, Department of PediatricsYale School of MedicineNew HavenConnecticutUSA
| | - Clifford M. Takemoto
- Division of Clinical HematologySt. Jude Children's Research HospitalMemphisTennesseeUSA
| |
Collapse
|
49
|
A Survey of Parents on the Effects of COVID-19 Pandemic on Children Receiving Antileukemic Therapy. J Pediatr Hematol Oncol 2021; 43:e740-e741. [PMID: 33093350 DOI: 10.1097/mph.0000000000001969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
50
|
Kebudi R, Kurucu N, Tuğcu D, Hacısalihoğlu Ş, Fışgın T, Ocak S, Tokuç G, Nihal Özdemir G, Bozkurt C, İnce D, Aras S, Ayçiçek A, Aksoy BA, Karadaş N, Öztürk G, Orhan MF, Ataseven E, Akbayram S, Yılmaz E, Tüfekçi Ö, Vural S, Akyay A, Ayhan AC, Kılıç S, Uzel VH, Düzenli Y, Kazancı EG, Acıpayam C, Elli M, Tanyeli A, Karakas Z, Somer A, Kara A. COVID-19 infection in children with cancer and stem cell transplant recipients in Turkey: A nationwide study. Pediatr Blood Cancer 2021; 68:e28915. [PMID: 33538100 PMCID: PMC7995085 DOI: 10.1002/pbc.28915] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 12/19/2020] [Accepted: 01/07/2021] [Indexed: 01/08/2023]
Affiliation(s)
- Rejin Kebudi
- Pediatric Hematology‐OncologyInstitute of OncologyIstanbul UniversityIstanbulTurkey
| | - Nilgün Kurucu
- Department of Pediatric OncologyCancer InstituteHacettepe University Faculty of MedicineAnkaraTurkey
| | - Deniz Tuğcu
- Department of Pediatric Hematology‐Oncologyİstanbul University Faculty of MedicineIstanbulTurkey
| | - Şadan Hacısalihoğlu
- Department of Pediatric Hematology‐OncologySağlık Bilimleri University Kanuni Sultan Süleyman Training and Research HospitalIstanbulTurkey
| | - Tunç Fışgın
- Department of Pediatric Hematology Pediatric Stem Cell TransplantationAltınbaş University Medical Park HospitalIstanbulTurkey
| | - Süheyla Ocak
- Department of Pediatric Hematology‐OncologyCerrahpaşa University Faculty of MedicineIstanbulTurkey
| | - Gülnur Tokuç
- Department of Pediatric OncologyMarmara University Faculty of MedicineIstanbulTurkey
| | - Gül Nihal Özdemir
- Department of Pediatric Hematology‐OncologySağlık Bilimleri University Kanuni Sultan Süleyman Training and Research HospitalIstanbulTurkey
| | - Ceyhun Bozkurt
- Department of Pediatric Hematology Pediatric Stem Cell TransplantationAltınbaş University Medical Park HospitalIstanbulTurkey
| | - Dilek İnce
- Department of Pediatric OncologyDokuz Eylül University Faculty of MedicineİzmirTurkey
| | - Seda Aras
- Department of Pediatric OncologyMarmara University Faculty of MedicineIstanbulTurkey
| | - Ali Ayçiçek
- Department of Pediatric Hematology‐OncologySağlık Bilimleri University Kanuni Sultan Süleyman Training and Research HospitalIstanbulTurkey
| | - Başak Adaklı Aksoy
- Department of Pediatric Hematology Pediatric Stem Cell TransplantationAltınbaş University Medical Park HospitalIstanbulTurkey
| | - Nihal Karadaş
- Department of Pediatric HematologyEge University Faculty of MedicineİzmirTurkey
| | - Gülyüz Öztürk
- Department of Pediatric Hematology and Pediatric Stem Cell TransplantationAcıbadem Altunizade HospitalIstanbulTurkey
| | - Mehmet Fatih Orhan
- Department of Pediatric Hematology‐OncologySakarya University Faculty of MedicineSerdivanTurkey
| | - Eda Ataseven
- Department of Pediatric OncologyEge University Faculty of MedicineİzmirTurkey
| | - Sinan Akbayram
- Department of Pediatric Hematology‐OncologyGaziantep University Faculty of MedicineGaziantepTurkey
| | - Ebru Yılmaz
- Department of Pediatric Hematology‐OncologyErciyes University Faculty of MedicineKayseriTurkey
| | - Özlem Tüfekçi
- Department of Pediatric HematologyDokuz Eylül University Faculty of MedicineİzmirTurkey
| | - Sema Vural
- Department of Pediatric OncologySağlık Bilimleri University Hamidiye Şişli Etfal Training and Research HospitalIstanbulTurkey
| | - Arzu Akyay
- Department of Pediatric Hematology‐Oncologyİnönü University Faculty of MedicineMalatyaTurkey
| | - Aylin Canbolat Ayhan
- Department of Pediatric Hematologyİstanbul Medeniyet University Faculty of MedicineIstanbulTurkey
| | - Suar Kılıç
- Department of Pediatric Hematology‐OncologySağlık Bilimleri University Ümraniye Training and Research HospitalIstanbulTurkey
| | - Veysiye Hülya Uzel
- Department of Pediatric Hematology‐OncologyDicle University Faculty of MedicineTurkey
| | - Yeter Düzenli
- Department of Pediatric Hematology‐OncologySağlık Bakanlığı Erzurum Training and Research HospitalErzurumTurkey
| | - Elif Güler Kazancı
- Department of Pediatric Hematology‐OncologySağlık Bilimleri University Bursa Yüksek İhtisas Training and Research HospitalBursaTurkey
| | - Can Acıpayam
- Department of Pediatric Hematolology‐OncologyKahramanmaraş Sütçü İmam University Faculty of MedicineKahramanmaraşTurkey
| | - Murat Elli
- Department of Pediatric Hematology‐Oncology and Bone Marrow Transplantationİstanbul Medipol UniversityIstanbulTurkey
| | - Atilla Tanyeli
- Department of Pediatric Stem Cell TransplantationMemorial Şişli HospitalIstanbulTurkey
| | - Zeynep Karakas
- Department of Pediatric Hematology‐Oncologyİstanbul University Faculty of MedicineIstanbulTurkey
| | - Ayper Somer
- Department of Pediatric Infectious Diseaseİstanbul University Faculty of MedicineIstanbulTurkey
| | - Ateş Kara
- Department of Pediatric Infectious DiseaseHacettepe University Faculty of MedicineAnkaraTurkey
| |
Collapse
|