Causes of transfer and mortality in children with oncohematological diseases admitted to the intensive care unit

Abstract

The last few decades survival rates of children with hematologic malignancies have improved significantly, due to a potentially curative chemotherapy protocols, the expansion of biological knowledge and innovative methods of therapy. However oncohematological pediatric patients are at high risk for rapid clinical deterioration due to numerous factors such as the severity of the underlying condition, interventions toxicity and associated immunosuppression. Using aggressive tactics of therapy with oncohematological diseases in children is also associated with complications and life-threatening events that lead to admission to the pediatric intensive care unit. Historically, these children have been considered as poor candidates for intensive care. Discussions around the transfer of children with hematological malignancies to intensive care units and also the expected prognosis raised complicate and delicate questions, especially from an ethical point of view. Despite the general tendency of improved survival rate, mortality in the intensive care unit on hematological malignancies children, unfortunately, is still high and, in comparison to adults, has remained relatively invariable over the past decades. These findings highlight the necessity for research in this group of patients.