Outcomes for paediatric acute leukaemia patients admitted to the paediatric intensive care unit
Por:
Marina Caballero Bellón, Faura A, Margarit A, Bobillo-Perez S, Català-Temprano A, Alonso-Saladrigues A, Conde N, Balaguer-Gargallo M, Rives-Solà S and Jordán-García I
Publicada:
1 mar 2022
Ahead of Print:
1 oct 2021
Categoría:
Pediatrics, perinatology and child health
Resumen:
Children with acute leukaemia (AL) are a high-risk population for infections and life-threatening conditions requiring paediatric intensive care unit (PICU) admission, presenting an increased mortality rate. A few literature exists about PICU outcomes in this kind of patients, especially with haematopoietic stem cell transplant (HSCT) background. We investigated the clinical and epidemiological characteristics of these patients as well as their outcomes. A retrospective, single-centre analytical/observational study was conducted from January 2011 to December 2018 in the PICU of a tertiary care hospital. AL patients from 28 days to 18 years old admitted to the PICU were included, excluding those with histories of HSCT or CAR T-cell therapy. We collected epidemiological and clinical characteristics, laboratory and microbiology results and outcomes. Forty-three patients with AL required urgent admission (35 lymphoblastic and 8 myeloblastic) for 63 different episodes. The main reasons were sepsis (21, 33.3%), hyperleukocytosis (12, 19%), respiratory failure (11, 17.5%) and seizures (8, 12.7%). Nineteen (30.2%) required inotropic support, and fifteen (23.8%) required mechanical ventilation. Three patients died at the hospital (3/43, 6.9%). Sixty-day mortality was 9.3%, and 1-year mortality was 13.9%. There was no differences regarding the type of AL and 60-day mortality (log-rank 2.652, p = 0.103).
Conclusion: In our study, the main cause of admission for AL patients was infection, which was associated to more severity and longer hospital admission.
What is Known:
center dot Acute leukaemia is the most common childhood cancer. Admission to a paediatric intensive care unit is required in 30% of children with acute leukaemia.
center dot Regarding the outcomes of children with acute leukaemia that require admission to the intensive care unit data are scarce.
What is New:
center dot Mortality in acute leukaemia patients admitted to the paediatric intensive care unit is lower than that of patients with a history of stem cell therapy but higher than that of patients with solid tumours.
center dot The main reason for admission was sepsis, which is related in literature to more severity and long length of stay.
Filiaciones:
Marina Caballero Bellón:
Department of Haematology/Oncology, Hospital Sant Joan de Déu, Barcelona, Spain
Faura A:
Department of Haematology/Oncology, Hospital Sant Joan de Déu, Barcelona, Spain
Margarit A:
Department of Haematology/Oncology, Hospital Sant Joan de Déu, Barcelona, Spain
Bobillo-Perez S:
Paediatric Intensive Care Unit, Hospital Sant Joan de Déu, University of Barcelona, Passeig de Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Barcelona, Spain.
Immunological and Respiratory Disorders, Paediatric Critical Patient Research Group, Institut de Recerca Sant Joan de Déu, University of Barcelona, Barcelona, Spain.
Català-Temprano A:
Department of Haematology/Oncology, Hospital Sant Joan de Déu, Barcelona, Spain
Centro de Investigación Biomédica en Red de Enfermedades Raras [Biomedical Research Networking Center On Rare Diseases] (CIBERER), Instituto de Salud Carlos III [Carlos III Health Institute], Madrid, Spain
Alonso-Saladrigues A:
Department of Haematology/Oncology, Hospital Sant Joan de Déu, Barcelona, Spain
Conde N:
Department of Haematology/Oncology, Hospital Sant Joan de Déu, Barcelona, Spain
Balaguer-Gargallo M:
Paediatric Intensive Care Unit, Hospital Sant Joan de Déu, University of Barcelona, Passeig de Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Barcelona, Spain
Immunological and Respiratory Disorders, Paediatric Critical Patient Research Group, Institut de Recerca Sant Joan de Déu, University of Barcelona, Barcelona, Spain
Rives-Solà S:
Department of Haematology/Oncology, Hospital Sant Joan de Déu, Barcelona, Spain
Centro de Investigación Biomédica en Red de Enfermedades Raras [Biomedical Research Networking Center On Rare Diseases] (CIBERER), Instituto de Salud Carlos III [Carlos III Health Institute], Madrid, Spain
Jordán-García I:
Paediatric Intensive Care Unit, Hospital Sant Joan de Déu, University of Barcelona, Passeig de Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Barcelona, Spain
Paediatric Infectious Diseases Research Group, Institut de Recerca Sant Joan de Déu, CIBERESP, Barcelona, Spain
Open Access
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