ICU Admission in Children With Acute Lymphoblastic Leukemia in Sweden: Prevalence, Outcome, and Risk Factors
| Autor: | Josefine Palle, Johan E. Svahn, Anna Nilsson, Lisa Törnudd, Ida Hed Myrberg, Lars Mikael Broman, Ulrika Norén-Nyström, Susanna Ranta, Katarina von Schewelov, Håkan Kalzén, Mats Heyman, Urban Fläring, Karin Mellgren, Arja Harila-Saari, Lene Karlsson, Jonas Abrahamsson, Jonas Berner |
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| Rok vydání: | 2021 |
| Předmět: |
Pediatrics
medicine.medical_specialty Adolescent MEDLINE Psychological intervention Critical Care and Intensive Care Medicine Risk Factors hemic and lymphatic diseases Intensive care Prevalence Medicine Humans Child Childhood Acute Lymphoblastic Leukemia Retrospective Studies Sweden Childhood Cancer Registry business.industry Hazard ratio Infant Newborn Infant Precursor Cell Lymphoblastic Leukemia-Lymphoma medicine.disease Icu admission Leukemia Intensive Care Units Child Preschool Pediatrics Perinatology and Child Health business |
| Zdroj: | Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies. 22(12) |
| ISSN: | 1529-7535 |
| Popis: | Objectives Despite progress in the treatment of childhood acute lymphoblastic leukemia, severe complications are common, and the need of supportive care is high. We explored the cumulative prevalence, clinical risk factors, and outcomes of children with acute lymphoblastic leukemia, on first-line leukemia treatment in the ICUs in Sweden. Design A nationwide prospective register and retrospective chart review study. Setting Children with acute lymphoblastic leukemia were identified,and demographic and clinical data were obtained from the Swedish Childhood Cancer Registry. Data on intensive care were collected from the Swedish Intensive Care Registry. Data on patients with registered ICU admission in the Swedish Childhood Cancer Registry were supplemented through questionnaires to the pediatric oncology centers. Patients All 637 children 0-17.9 years old with acute lymphoblastic leukemia diagnosed between June 2008 and December 2016 in Sweden were included. Interventions None. Measurements and main results Twenty-eight percent of the children (178/637) were admitted to an ICU at least once. The Swedish Intensive Care Registry data were available for 96% of admissions (241/252). An ICU admission was associated with poor overall survival (hazard ratio, 3.25; 95% CI, 1.97-5.36; p ≤ 0.0001). ICU admissions occurred often during early treatment; 48% (85/178) were admitted to the ICU before the end of the first month of acute lymphoblastic leukemia treatment (induction therapy). Children with T-cell acute lymphoblastic leukemia or CNS leukemia had a higher risk of being admitted to the ICU in multivariable analyses, both for early admissions before the end of induction therapy and for all admissions during the study period. Conclusions The need for intensive care in children with acute lymphoblastic leukemia, especially for children with T cell acute lymphoblastic leukemia and CNS leukemia, is high with most admissions occurring during early treatment. |
| Databáze: | OpenAIRE |
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