Evaluation of pediatric patients with an oncologic emergency: Single center experience

Abstract

In this study, we aimed to prospectively analyze the emergency diagnosis and clinical characteristics of the oncologic emergency patients admitted, as well as to evaluate the approach considerations to the cases, their treatment, patient outcomes and the prognostic factors. A total of 88 oncologic emergency patients (90 oncologic emergency hospitalizations), except for febrile neutropenia, were admitted to the pediatric oncology department between July 2014 and December 2015. A total of 30 cases of tumor lysis syndrome, 19 hyperleukocytosis, 11 convulsion, 7 spinal cord compression, 7 hemorrhagic cystitis, 9 pleural effusion, 6 vena cava superior syndrome, 4 typhlitis, 3 anuria, 4 gastrointestinal bleeding, 3 hypercalcemia, 4 acute respiratory distress syndrome, 2 acute massive hepatomegaly and 1 increased intracranial pressure were identified. Sixty-five (72.2%) of the study patients had a primary oncologic disease, whereas 25 (27.8%) had a recurring condition. The most common presenting complaint was fever (23.3%) followed by breathing difficulties (22.2%). Fifty-nine patients (65.6%) recovered and were discharged home, while 31 cases (34.4%) died. Tumor lysis syndrome was the most frequently encountered emergency condition in the pediatric oncology patient group. Oncologic emergencies need to be approached quickly and systematically in the light of current scientific knowledge.

Pediatric Emergency Care for Children and Adolescents with Cancer: Causes of Consultation and Factors Associated with Hospitalization

“…The most frequent neoplasms in pediatric patients who attended the institution's PE were CNS tumors (27.5% of cases). These findings differ from those of another study, where 25.9% of the cases were due to acute lymphoblastic leukemia (ALL), which was the most frequent neoplasm 20 . Similarly, in other publication the authors found that 41.3% of children consulted at the PE had ALL 19 .…”

“…Another retrospective report studied the main complaints of children with cancer in a general PE, but restricted to patients undergoing active cancer treatment 19 . In a study from Turkey, 88 patients admitted to the Department of Pediatric Oncology who presented with oncological emergencies were prospectively analyzed 20 . To the best of the current knowledge, no studies have addressed specific PE care in a cancer hospital.…”