Psychopharmacology in the Pediatric Oncology and Bone Marrow Transplant Units: Antipsychotic Medications Palliate Symptoms in Children with Cancer

2020 ◽  
Vol 30 (8) ◽  
pp. 486-494
Author(s):  
Orit Peled ◽  
Orly Lavan ◽  
Jerry Stein ◽  
Inbal Vinograd ◽  
Anat Yahel ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplant ◽  
Pediatric Oncology ◽  
Marrow Transplant ◽  
Children With Cancer ◽  
Antipsychotic Medications

Platelet refractoriness and alloimmunization in pediatric oncology and bone marrow transplant patients

Transfusion ◽  
1995 ◽  
Vol 35 (8) ◽  
pp. 645-652 ◽  
Author(s):  
DE Hogge ◽  
M McConnell ◽  
C Jacobson ◽  
HJ Sutherland ◽  
WB Benny ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplant ◽  
Pediatric Oncology ◽  
Marrow Transplant ◽  
Transplant Patients

Pediatric sibling donor bone marrow transplant: Assessing distress in donors and family members

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e20625-e20625
Author(s):  
P. S. Hinds ◽  
W. Pelletier ◽  
M. A. Alderfer ◽  
S. Davies ◽  
R. D. Pentz
Keyword(s):  
Bone Marrow ◽  
Grounded Theory ◽  
Patient Care ◽  
Bone Marrow Transplant ◽  
Marrow Transplant ◽  
Children With Cancer ◽  
Sibling Donor ◽  
Care Giving ◽  
Pediatric Transplantation ◽  
Donor Bone Marrow

e20625 Background: When a child is diagnosed with cancer, the entire family is affected. In qualitative studies, 28–81% of siblings of children with cancer display behavioral maladjustment. Quantitative studies show similar findings, documenting up to a three-fold increase in clinically significant behavioral problems among siblings of children with cancer. Methods: In order to better understand sibling distress we conducted 3–4 interviews using grounded theory methodology (a qualitative strategy to explore common themes and develop theory) with each family member over 9 years old of 7 families with a child undergoing a sibling donor bone marrow transplant for cancer or sickle cell anemia. Participants also completed standardized scales related to coping. Results: Of the 29 subjects interviewed, 6 were African American, 4 Hispanic and 19 white. Six parents had at least a college degree and income was evenly distributed from $5,000 to >$80,000 a year. Children, including 4 patients, 6 donor siblings and 5 other siblings, ranged in age from 9 to 18. Based on the grounded theory analysis of each interview, we theorize that siblings experience less distress if the parents share the patient care giving. Our data support this hypothesis, with analysis of interviews indicating improved coping in families that shared care giving for the transplant recipient, and increased distress in families in which all the patient care giving was performed by the mother, a commonly used strategy. Conclusion: In order to potentially facilitate increased family functioning and decrease caregiver burden, parents should be encouraged to share care giving when feasible. Our study shows that systematic interviews can explore the family experience of pediatric transplantation and allow development of improved support systems for families of children undergoing sibling donor bone marrow transplantation. No significant financial relationships to disclose.

Youth and Pet Survivors: Exploring the Experiences of Pediatric Oncology and Bone Marrow Transplant Patients in a Virtual Animal-Assisted Therapy Pen Pal Program

2020 ◽  
Vol 37 (6) ◽  
pp. 368-376
Author(s):  
Anne Ingalls Gillespie ◽  
Madalynn Neu
Keyword(s):  
Bone Marrow ◽  
Children And Adolescents ◽  
Bone Marrow Transplant ◽  
Pediatric Oncology ◽  
Well Being ◽  
Marrow Transplant ◽  
Letter Writing ◽  
Animal Assisted Therapy ◽  
Medical Illness ◽  
Pen Pal

Introduction: YAPS™ (Youth and Pet Survivors™) is a form of virtual animal-assisted therapy (AAT), a pen pal program designed for children and adolescents with cancer and/or having a bone marrow transplant (BMT) to engage in virtual visits with a dog or a cat (who has also been treated for cancer or serious medical illness) through letter writing and pictures. The purpose of this qualitative descriptive study was to explore the experiences of YAPS participants over time and to explore how virtual AAT may be an additional or alternative intervention to the traditional form of AAT, which involves live visits with animals, primarily dogs. Method: Open-ended, face-to-face interviews were conducted throughout the participants’ involvement with their animal pen pal. Interviews were digitally recorded. Data were analyzed using a content analysis method. Results: Fifteen children and adolescents, aged 7 to 16 years, participated. Three main themes and five subthemes were found, including connection, shared experience, and friendship. Themes suggested that a virtual AAT letter writing program can provide a source of fun and a way to process the cancer experience with a dog or cat pen pal who has also faced cancer or serious medical treatment. Discussion: Interventions that promote well-being for pediatric oncology and BMT patients are needed, and virtual AAT seems to be one such intervention suited for those who have an affinity for animals and enjoy letter writing. The findings of this study also presented an exciting and intriguing gap for further research in virtual AAT.

Delirium documentation in hospitalized pediatric patients with cancer

2021 ◽  
pp. 1-4
Author(s):  
Kelly Lastrapes ◽  
Malisa Dang ◽  
J. Brian Cassel ◽  
Tamara Orr ◽  
Tracye Proffitt ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplant ◽  
Pediatric Oncology ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Marrow Transplant ◽  
Screening Tools ◽  
Cancer Center ◽  
Patients With Cancer ◽  
Transplant Patients

Abstract Objective Screening tools for delirium are being used more consistently in pediatric critical care. However, screening is not universal, and delirium may be underdiagnosed, misdiagnosed, or undocumented in hospitalized patients. We evaluated the identification and documentation of delirium in pediatric oncology and bone marrow transplant patients. Method A retrospective chart review on all hospitalized pediatric oncology and bone marrow transplant patients admitted to an Academic Cancer center between 2013 and 2016. Patients aged less than 21 years of age with active cancer were included. Patients with major psychiatric conditions, developmental delays, or autism were excluded. Data were collected to characterize documentation concerning the identification and diagnosis of delirium. Results Of 201 hospitalization records, 54 (26.9%) admissions from 109 unique patients had documentation of delirium. The overall documented incidence of delirium was 3.2% of hospitalizations or 8.2% of unique patients. Patients prescribed opioids and benzodiazepines were more likely to have documentation of delirium. ICD coding under-reported delirium while physician documentation was inaccurate in 26% (53/201) when compared with the chart review. Significance of results Delirium was frequently undocumented or miscoded. Implementing a validated, universal screening tool for delirium may improve identification and clinical outcomes.

scholarly journals Voriconazole Monitoring in Children with Invasive Fungal Infections

2015 ◽  
Vol 20 (1) ◽  
pp. 17-23 ◽  
Author(s):  
Lyn Tucker ◽  
Tara Higgins ◽  
Eric F. Egelund ◽  
Baiming Zou ◽  
Vini Vijayan ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplant ◽  
Pediatric Oncology ◽  
Trough Concentration ◽  
Fungal Infections ◽  
Dose Range ◽  
Marrow Transplant ◽  
Invasive Fungal Infections ◽  
Transplant Patients ◽  
Trough Concentrations

OBJECTIVES: The primary objective of this study was to determine the optimal daily dose of voriconazole required to achieve therapeutic trough concentrations in children 1 month to 18 years of age. The secondary objective was to analyze the association between voriconazole trough concentrations and clinical and microbiological outcomes, toxicity, and mortality. METHODS: This study was a retrospective chart review (October 2009 to August 2012) of pediatric oncology/bone marrow transplant patients with proven or probable invasive fungal infections treated with intravenous or oral voriconazole. Patients were excluded if they were older than 18 years of age, had no voriconazole concentrations drawn during the study period, or received voriconazole prior to the study period. RESULTS: Thirty-four patients were reviewed; 11 patients met all criteria for inclusion. There were 6 males and 5 females, with a median age of 8 years (range: 0.8–14.8) and a median weight of 27 kg (range: 9–74). Doses were adjusted to a median 6 mg/kg/dose (range: 3–8.7 mg/kg/dose) given every 8 (n = 5) to 12 (n = 6) hours; dose regimens varied greatly. All but 1 child achieved a voriconazole trough concentration above 1 mg/L; 7 children had a trough concentration above 2 mg/L. The median time to achieve a therapeutic trough concentration was 11 days (range: 6–37 days). Therapy failed for 4 of 11 patients, including 3 of the 4 youngest patients (p=0.022). Three of the 4 for whom therapy failed also had voriconazole trough concentrations less than 2 mg/L; this did not reach statistical significance. Voriconazole therapy was discontinued in 2 patients due to toxicity. CONCLUSIONS: This study confirmed that voriconazole pharmacokinetics vary greatly in pediatric oncology/bone marrow transplant patients. “Optimal” doses varied over nearly a 3-fold range. Younger patients may be at greater risk of poor outcomes and may require additional monitoring and dose adjustment.

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