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[Cancer in the first 18 months of life]
Andrea Urtasun Erburu1, Maria José Herrero Cervera2, Adela Cañete Nieto3
1Unidad Onco-Hematología Pediátrica, Hospital Universitario y Politécnico La Fe, Valencia, España; Plataforma de Farmacogenética, Instituto de Investigación Sanitaria La Fe, Hospital Universitario y Politécnico La Fe, Valencia, España; Servicio de Oncología y Hematología Pediátrica, Hospital Sant Joan de Deu, Barcelona, España.
Insights
Childhood cancer presents unique challenges in patients under 18 months. Early diagnosis and understanding specific features of pediatric cancers are crucial for improving survival rates and reducing long-term health issues.
Area of Science:
- Pediatric Oncology
- Hematology
- Childhood Cancer Research
Background:
- Oncological-hematological diseases are a leading cause of non-traumatic mortality and morbidity in children.
- Infants under 18 months present distinct clinical, diagnostic, and therapeutic characteristics.
- Understanding these unique features is vital for improving outcomes in young cancer patients.
Purpose of the Study:
- To analyze the clinical, diagnostic, and therapeutic variables of oncological-hematological conditions in patients under 18 months.
- To identify key features influencing survival and morbidity in this specific pediatric population.
Main Methods:
- Retrospective, descriptive study.
- Analysis of clinical, diagnostic, and therapeutic data.
- Inclusion of patients under 18 months receiving chemotherapy between January 2007 and August 2019.
Main Results:
- 72 patients were diagnosed with 76 cancers requiring chemotherapy.
- Leukemia, neuroblastoma, and central nervous system tumors were most common.
- Over half of diagnoses occurred at advanced stages, with 23.6% of solid tumors presenting with metastases. Genetic alterations were frequently identified.
Conclusions:
- Cancer in early childhood is a significant diagnostic and therapeutic challenge due to diverse presentations and genetic factors.
- Early and effective management requires specialized knowledge of these pediatric cancers.
- Further research into the unique aspects of infant cancers is essential.
Introduction:
Oncological-haematological disease continues to be the first cause of non-traumatic mortality in childhood, as well as a significant cause of morbidity. The patient less than 18-months-old has special clinical, diagnostic, and therapeutic features that all paediatricians are interested in determining, with the aim of achieving greater survival and a lower morbidity throughout the lives of their patients.
Material And Methods:
A retrospective, descriptive study was carried out using the clinical, diagnostic, and therapeutic variables in patients less than 18-months-old diagnosed with an oncological-haematological that received chemotherapy in a Paediatric Oncology Unit between January 2007 and August 2019.
Results:
A total of 72 patients were diagnosed with 76 cancers that required chemotherapy. The most common cancer was leukaemia (21 patients), followed by neuroblastoma (15 patients), and tumours of the central nervous system (12 patients). The presentation of "life-threatening symptoms" was seen in 20.8% of cases, particularly in tumours of neural origin (13/15). Although 18% of patients showed no symptoms on diagnosis, just over half (51%) of the diagnoses took place in the "advanced stages". Particularly in the case of solid tumours in which 23.6% were diagnosed with metastases. A significant percentage of genetic alterations implicated in the aetiopathogenesis of the different cancers were found.
Conclusions:
Cancer in the first stages of life is a diagnostic and therapeutic challenge due to its phenotypical diversity, its genetic load, and its therapeutic difficulties. Knowledge of its particular features is essential for its early and effective approach.
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