High need for intensive care in paediatric acute myeloid leukaemia: A population-based study
Susanna Ranta1,2, Lars Mikael Broman3,4, Jonas Abrahamsson5
1Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
Insights
Pediatric acute myeloid leukemia (AML) patients requiring intensive care unit (ICU) admission had a low treatment-related mortality rate. This suggests good ICU availability for critically ill children with AML in Sweden.
Area of Science:
- Pediatric Oncology
- Critical Care Medicine
- Hematology
Background:
- Childhood acute myeloid leukemia (AML) treatment carries a high risk of life-threatening toxicity.
- Access to intensive care units (ICUs) is critical for managing severe complications in pediatric AML patients.
Purpose of the Study:
- To investigate the intensive care unit (ICU) admission rate among children with acute myeloid leukemia (AML) in Sweden.
- To evaluate the outcomes of pediatric AML patients admitted to the ICU.
Main Methods:
- Utilized data from the Swedish Childhood Cancer Registry (SCCR) and the Swedish Intensive Care Registry (SIR) for patients diagnosed between 2008 and 2016.
- Cross-referenced SCCR data with clinical questionnaire data from pediatric oncology centers and SIR data.
- Analyzed ICU admission rates and mortality for pediatric AML patients during first-line treatment.
Main Results:
- 46% of pediatric AML patients (58/126) were admitted to the ICU, with 17% admitted within one month of diagnosis.
- ICU mortality per admission was 12% overall and 6% during first-line treatment.
- A discrepancy was noted between SCCR (29%) and SIR (44%) reported ICU admission rates; all treatment-related deaths occurred during or after ICU care.
Conclusions:
- Despite a high ICU admission rate, treatment-related mortality during first-line therapy for childhood AML was low.
- The findings suggest adequate availability of ICU resources for critically ill pediatric AML patients in Sweden.
- Discrepancies between SCCR and SIR highlight the need for future validation of registry data.
Aim:
Risk of treatment-related life-threatening toxicity is high in childhood acute myeloid leukaemia (AML), and access to intensive care units (ICU) is crucial. We explored the ICU admission rate and outcome after intensive care in childhood AML in Sweden.
Methods:
Patients diagnosed between 2008 and 2016 were identified from the Swedish Childhood Cancer Registry (SCCR), a national quality registry. Data from SCCR was cross-referenced with clinical questionnaire data from paediatric oncology centers and the Swedish Intensive Care Registry (SIR), another national quality registry.
Results:
According to combined data, 46% of the children (58/126) were admitted to ICU, 17% (21/126) within 1 month from diagnosis. Overall, ICU mortality per admission was 12% and 6% during first-line treatment. There was a discrepancy between admission rate from the clinical questionnaires and SCCR (29%; 36/126 children) and SIR (44%; 55/126) All deaths during first-line treatment occurred at or after ICU care.
Conclusion:
Although admission rate under AML treatment was high, the treatment-related mortality under first-line treatment was low. No child died under first-line treatment without admission to ICU, suggesting good availability. The discrepancy between the two registries, SCCR and SIR, highlights the need for future validation of registry data.
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