Pediatric acute lymphoblastic leukemia: Proportion of patients who continue hospital visits

Maeda, Naoko; Saito, Akiko; Kada, Akiko; Imamura, Toshihiko; Hayakawa, Akira; Horibe, Keizo; Satō, Atsushi

doi:10.1111/ped.13528

Cited by 3 publications

(4 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Considering that the most common problems encountered by CCSs in adulthood were related to late complications, support for LTFU continuation is an important concern. However, although many Western pediatric cancer treatment research groups have created long‐term follow‐up guidelines and a systematic LTFU has been established, in Japan LTFUs are determined individually by each physician 14 . Moreover, while intensive medical care, such as pediatric cancer center hospitals, is being promoted in Japan, it is noteworthy that many CCSs need outpatient visits to be convenient and tend to choose a neighborhood clinic rather than the pediatric department as the ideal department for receiving treatment, as shown in our study.…”

Section: Discussionmentioning

confidence: 99%

“…Although long‐term follow up (LTFU) in the form of regular outpatient visits after treatment completion is important for early detection of late complications, early treatment, and better understanding of the psychosocial problems encountered by CCSs, the interruption of LTFU for various reasons has been reported 14–16 . It is important to define the support needs of CCSs and to clarify the factors responsible for LTFU discontinuation but it remains a challenge for medical institutions to conduct surveys targeting CCSs who have discontinued LTFU.…”

mentioning

confidence: 99%

See 1 more Smart Citation

A questionnaire study of support for adult survivors of childhood cancer

Terada

Kakuda

Iida³

et al. 2022

Pediatrics International

View full text Add to dashboard Cite

Background: Childhood cancer survivors (CCSs) entering adulthood experience different problems, including late therapy-related complications. Long-term follow up (LTFU) is important for early intervention and psychosocial support for CCSs with late complications but it is frequently discontinued. This study aimed (i) to identify clearly the factors responsible for LTFU discontinuation, and (ii) to define the support needs of CCSs. Methods: From July, 2017 to March, 2019 we conducted a questionnaire survey of 121 CCSs aged ≥ 18 years at the time of the survey to investigate people who have experienced childhood cancer and identify their support needs. This was conducted in cooperation with patient associations throughout Japan. The LTFU levels were determined by CCSs themselves based on their treatment history. Long-term follow-up rates and LTFU discontinuation factors were assessed using the Kaplan-Meier method and the Cox proportional-hazards model. Results: Late complications were the most common problem encountered by CCSs (80%). The most common support need was "explanation of late complications by a physician," reported by 86.9% of respondents. The rate of LTFU continuation decreased over time. The LTFU was discontinued both for physicians' reasons (35.6%) and patients' reasons (64.4%). Not knowing the extent or level of one's LTFU was reported to be an independent factor (P < 0.05) preventing LTFU continuation. As necessary support to continue LTFU, 67.9% of respondents stated the need for "explanation of LTFU by a doctor" and 60.7% stated "convenience of outpatient visit". Conclusions: Childhood cancer survivors require support, especially for late complications. It is necessary to continue LTFU, raising LTFU awareness among physicians and CCSs.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

A questionnaire study of support for adult survivors of childhood cancer

Terada

Kakuda

Iida³

et al. 2022

Pediatrics International

View full text Add to dashboard Cite

show abstract

“…This disease accounts for 30%–40% of malignant tumors in children under 15 years old. At present, the overall survival rate of children with acute lymphoblastic leukemia (ALL) exceeds 80%, and the survival rate ranges from 60% to 70% in children with acute myeloid leukemia (AML) 1–4 . However, myelosuppression caused by chemotherapy also increases the chance of infection and even severe sepsis.…”

Section: Introductionmentioning

confidence: 99%

“…At present, the overall survival rate of children with acute lymphoblastic leukemia (ALL) exceeds 80%, and the survival rate ranges from 60% to 70% in children with acute myeloid leukemia (AML). [1][2][3][4] However, myelosuppression caused by chemotherapy also increases the chance of infection and even severe sepsis. Recent studies have found that the prevalence of children with acute leukemia who need to be transferred to the pediatric intensive care unit (PICU) for supportive treatment due to deterioration of their condition is as high as 38%-40% during the whole treatment process, and a large proportion of these children had sepsis.…”

Section: Introductionmentioning

confidence: 99%

Prognostic factors of sepsis in children with acute leukemia admitted to the pediatric intensive care unit

Jin

Wang

et al. 2023

Pediatric Blood & Cancer

View full text Add to dashboard Cite

Objective:To analyze the prognostic factors of sepsis in children with acute leukemia admitted to the pediatric intensive care unit (PICU) and to compare the efficacy of different scoring systems for predicting the outcome of children. Methods:Patients with an acute leukemia diagnosis admitted to a tertiary care university hospital PICU due to sepsis during chemotherapy between May 2015 and August 2022 were retrospectively analyzed through an electronic medical record system.Results: During this period, 693 children with acute leukemia initially diagnosed were admitted to the center, and 155 (22.3%) of them were transferred to PICU due to deterioration of the disease during treatment. Total 109 (70.3%) patients were transferred to PICU due to sepsis. Here, 17 patients was excluded (prior treatment from another hospital; referring from other hospitals; discontinued treatment; incomplete medical record). Of the 92 patients studied, the mortality rate was 35.9%. Multivariate analysis revealed that remission status, lactate level, invasive mechanical ventilation (IMV), and inotropic support within 48 hours after PICU transfer were independent risk factors for PICU mortality. The pediatric sequential organ failure assessment (PSOFA) score had the greatest predictive validity for hospital mortality (area under the receiver operating characteristic curve [AUROC]: 0.83, 95% confidence intervals [CI]: 0.74-0.92), followed by the pediatric early warning score (PEWS) (0.82, 0.73-0.91) and pediatric critical illness score (PCIS) (0.79, 0.69-0.88). Conclusion:The mortality rate among children with acute leukemia complicated with sepsis is high after being transferred to the PICU. Various scoring systems can be used to monitor the clinical status of patients, identify sepsis early, detect critical illness, and determine the optimal time for transfer to the PICU for supportive treatment, thereby improving the prognosis of these patients.

show abstract

Late Effects Screening of Acute Lymphoblastic Leukemia Survivors in the Military Healthcare System

Zanetti

Warwick

Sicignano³

et al. 2022

Military Medicine

View full text Add to dashboard Cite

Introduction Pediatric acute lymphoblastic leukemia (ALL) survivors are a growing portion of the population with unique health screening needs. These survivors receive care within late effects oncology clinics and primary care clinics. Prior attempts to quantify compliance with follow-up recommendations have shown variable rates ranging from 28% to 73%. This study set out to assess rates of adherence to recommended health screening among pediatric ALL survivors within the U.S. DoD, identify potential risk factors contributing to patient compliance, and better define the prevalence of chronic health conditions. Materials and Methods This Institutional Review Board–approved, retrospective cohort study used data from the U.S. DoD MHS database and identified incident cases of pediatric ALL during 2007-2011 using a conservative case identification algorithm. Minimum duration of follow-up was instituted in order to ensure the entire study population had sufficient time for the assessment of each screening exam according to recommended guidelines. Rates of adherence to recommended screening measures were calculated across the full study follow-up period, and regression analyses assessed protective factors for compliance. Results One hundred and forty-four incident ALL cases were identified. During the follow-up period, 31.3% developed a new mental health diagnosis. In terms of recommended screening, 94.4% had an annual complete blood count for the entire study period, 90.3% had a liver function screening, 81.9% had an echocardiogram, 34% had a bone density scan, and 54.2% had a mental health visit. Adolescents were less likely to have a bone density scan (odds ratio [OR] 0.32, 95% CI, 0.11-0.95) or a mental health visit (OR 0.28, 95% CI, 0.11-0.7). Conclusion The MHS provides universal access to healthcare for all beneficiaries. In this population with universal access to care, there is increased compliance with screening recommendations. Our results reflect actual screening testing as opposed to general screening visits that have been previously reported in the literature. We also highlight the significant number of mental health diagnoses among pediatric ALL survivors.

show abstract

Pediatric acute lymphoblastic leukemia: Proportion of patients who continue hospital visits

Abstract: Further studies may be necessary to assess whether CCS who stopped visiting childhood cancer treatment facilities, actually received therapeutic intervention or appropriate screening for late effects as adults.

Cited by 3 publications

References 7 publications

A questionnaire study of support for adult survivors of childhood cancer

A questionnaire study of support for adult survivors of childhood cancer

Prognostic factors of sepsis in children with acute leukemia admitted to the pediatric intensive care unit

Late Effects Screening of Acute Lymphoblastic Leukemia Survivors in the Military Healthcare System

Contact Info

Product

Resources

About