Pediatric Oncologic Emergencies

Stephanos, Kathleen; Picard, Lindsey

doi:10.1016/j.emc.2018.04.007

Cited by 12 publications

(18 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Phosphate levels lower than 2.5 mg/dL were reported in 49% of patients with advanced cancer whereas a lower fraction (23%) had phosphate levels less than 2.0 mg/dL (27). Hyperphosphatemia (phosphate > 4.5 mg/dL) is related to TLS, particularly in hematologic malignancies, and occurs more frequently as a consequence of chemotherapy than in spontaneous TLS (28).…”

Section: Physiopathology Of Electrolyte Disordersmentioning

confidence: 98%

Electrolyte Disorders Induced by Antineoplastic Drugs

et al. 2020

View full text Add to dashboard Cite

The use of antineoplastic drugs has a central role in treatment of patients affected by cancer but is often associated with numerous electrolyte derangements which, in many cases, could represent life-threatening conditions. In fact, while several anti-cancer agents can interfere with kidney function leading to acute kidney injury, proteinuria, and hypertension, in many cases alterations of electrolyte tubular handling and water balance occur. This review summarizes the mechanisms underlying the disturbances of sodium, potassium, magnesium, calcium, and phosphate metabolism during anti-cancer treatment. Platinum compounds are associated with sodium, potassium, and magnesium derangements while alkylating agents and Vinca alkaloids with hyponatremia due to syndrome of inappropriate antidiuretic hormone secretion (SIADH). Novel anti-neoplastic agents, such as targeted therapies (monoclonal antibodies, tyrosine kinase inhibitors, immunomodulators, mammalian target of rapamycin), can induce SIADH-related hyponatremia and, less frequently, urinary sodium loss. The blockade of epidermal growth factor receptor (EGFR) by anti-EGFR antibodies can result in clinically significant magnesium and potassium losses. Finally, the tumor lysis syndrome is associated with hyperphosphatemia, hypocalcemia and hyperkalemia, all of which represent serious complications of chemotherapy. Thus, clinicians should be aware of these side effects of antineoplastic drugs, in order to set out preventive measures and start appropriate treatments.

show abstract

Section: Physiopathology Of Electrolyte Disordersmentioning

confidence: 98%

Electrolyte Disorders Induced by Antineoplastic Drugs

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Treatments for the different components of TLS include volume expansion with intravenous fluids, diuresis with mannitol/furosemide, urinary alkalinization with sodium bicarbonate, uric acid reduction with allopurinol, febuxostat, rasburicase, and renal replacement therapy [ 20 – 22 , 30 , 36 ]. Despite these lifesaving measures, mortality rates following acute TLS are considerable, ranging from 7% to 51% [ 37 , 38 ]. In a study of 63 patients by Darmon et al ., AKI was the greatest predictor of death following TLS in hematologic malignancies.…”

Section: Discussionmentioning

confidence: 99%

Tumor lysis syndrome following ifosfamide monotherapy in metastatic osteosarcoma: a case report and review of the literature

et al. 2022

View full text Add to dashboard Cite

Background Tumor lysis syndrome is an oncologic emergency that involves multiple metabolic abnormalities and clinical symptoms such as acute renal failure, cardiac arrhythmias, seizures, and multiorgan failure, and may be fatal if not promptly recognized. Tumor lysis syndrome occurs most often in patients with hematologic malignancies, and relatively few cases have been described in patients with sarcoma. Case presentation A 64-year-old male of Asian heritage presented to his primary care physician with a right lower-extremity mass and was ultimately diagnosed with widely metastatic osteosarcoma. He was treated with one cycle of cisplatin and doxorubicin that was complicated by hypervolemia and hypoxic respiratory failure. Given concerns for volume overload, therapy was changed to single-agent, dose-reduced ifosfamide. After receiving one dose of ifosfamide 1 g/m2 (1.8 g total) intravenously over 1 hour, the patient developed renal failure, hyperuricemia, hyperkalemia, hyperphosphatemia, and lactic acidosis. The patient ultimately died from severe electrolyte abnormalities associated with tumor lysis syndrome. Conclusion This is the first instance of tumor lysis syndrome described in a patient with osteosarcoma undergoing ifosfamide monotherapy. Clinicians must be vigilant in identifying tumor lysis syndrome regardless of the malignancy type or chemotherapy regimen in order to prevent potentially fatal complications.

show abstract

“…In a series of infants with bacterial meningitis in the UK, 24% presented to the hospital >24 hours after symptom development8; this seemingly delayed presentation was associated with both increased mortality and neurologic morbidity 9. Other severe illnesses including stroke,10 11 malignancy12–14 and kernicterus15 16 can result in permanent injury and are also time-sensitive in terms of their need for definitive treatment. Furthermore, multiple jurisdictions in Canada, the USA and the UK have reported that children under 1 year of age are at greatest risk of death from medical conditions related to prematurity, congenital anomalies and infections with anywhere from 8% to 26% of deaths having some degree of preventability 8 17–19.…”

Section: Introductionmentioning

confidence: 99%

Severe illness getting noticed sooner – SIGNS-for-Kids: developing an illness recognition tool to connect home and hospital

Gilleland

Bayfield²,

Bayliss

et al. 2019

BMJ Open Qual

View full text Add to dashboard Cite

BackgroundDelays to definitive treatment for time-sensitive acute paediatric illnesses continue to be a cause of death and disability in the Canadian healthcare system. Our aim was to develop the SIGNS-for-Kids illness recognition tool to empower parents and other community caregivers to recognise the signs and symptoms of severe illness in infants and children. The goal of the tool is improved detection and reduced time to treatment of acute conditions that require emergent medical attention.MethodsA single-day consensus workshop consisting of a 17-member panel of parents and multidisciplinary healthcare experts with content expertise and/or experience managing children with severe acute illnesses was held. An a priori agreement of ≥85% was planned for the final iteration SIGNS-for-Kids tool elements by the end of the workshop.ResultsOne hundred percent consensus was achieved on a five-item tool distilled from 20 initial items at the beginning of the consensus workshop. The final items included four child-based items consisting of: (1) behaviour, (2) breathing, (3) skin, and (4) fluids, and one context-based item and (5) response to rescue treatments.ConclusionsSpecific cues of urgent child illness were identified as part of this initial development phase. These cues were integrated into a comprehensive tool designed for parents and other lay caregivers to recognise the signs of serious acute illness and initiate medical attention in an undifferentiated population of infants and children. Future validation and optimisation of the tool are planned.

show abstract

Pediatric Oncologic Emergencies

Cited by 12 publications

References 8 publications

Electrolyte Disorders Induced by Antineoplastic Drugs

Electrolyte Disorders Induced by Antineoplastic Drugs

Tumor lysis syndrome following ifosfamide monotherapy in metastatic osteosarcoma: a case report and review of the literature

Severe illness getting noticed sooner – SIGNS-for-Kids: developing an illness recognition tool to connect home and hospital

Contact Info

Product

Resources

About