Therapeutics for paediatric oncological emergencies

Abstract

Background With advancements in the field of oncology, cancer survival rates have improved dramatically but modern cancer treatments also come with an increasing number of disease and treatment-associated complications. This article provides an updated narrative review on the pathophysiology, clinical presentations and latest management strategies for common paediatric oncological emergencies. Methods An extensive PubMed ® search of all human studies in the English literature was performed in Clinical Queries for different oncology syndromes and conditions using the following Medical Subject Headings: “tumour lysis syndrome”, “hyperleukocytosis”, “disseminated intravascular coagulation”, “superior mediastinal syndrome”, “superior vena cava syndrome”, “sepsis”, “severe inflammatory response syndrome”, “acute respiratory distress syndrome”, “posterior reversible encephalopathy syndrome” and “reversible posterior leukoencephalopathy syndrome”. Categories were limited to clinical trials and reviews for ages from birth to 18 years. Results The general description, presentation and management of these oncologic emergencies are systematically described. Early recognition along with prompt and proactive treatment can reduce the chances of potential complications and improve the clinical outcomes, thereby improving not only survival rates in oncology patients but also their clinical outcomes and quality of life. Conclusions Oncologic emergencies are associated with significant mortality and morbidity. Healthcare professionals involved with the care of oncology patients must be vigilant of these emergencies.

Case Report: Primary Thoracic Low-Grade Fibromyxoid Sarcoma in a Young Girl Presenting With Mediastinal Mass Syndrome

“…Mediastinal mass syndrome (MMS) as a result of neoplastic growth represents an oncologic emergency, which can manifest as life-threatening cardiovascular decompensation as a result of mass effects on the surrounding anatomical structures (22,23). According to previous publications, patients have higher risk of acute cardiovascular decompensation if they present with orthopnea, stridor, wheeze, shortness of breath, syncope, and upper body edema; most of which were present in our patient (24,25).…”

Laboratory and clinical features of tumor lysis syndrome in children with non-Hodgkin lymphoma and evaluation of long-term renal functions in survivors

“…Its incidence can vary depending on factors such as tumor type, individual differences, and treatment plans. It is frequently observed in rapidly proliferating hematologic malignancies such as acute leukemia and non-Hodgkin lymphomas (NHL), while being less commonly observed in solid tumors [4][5][6]. In TLS, in addition to high proliferation rate, high tumor sensitivity to chemotherapy, advanced stage (stage III-IV), high serum lactate dehydrogenase (LDH) levels, bone marrow involvement and kidney involvement are well-known risk factors [1][2][3][4].…”