Transfusion Reactions in Pediatric Cancer Patients

Background: Transfusion is an essential component of supportive management for cancer patients with anemia and thrombocytopenia. It is generally safe; however, it has several risks and complications including those caused by transfusion reactions. This study aimed to describe transfusion reactions in pediatric cancer patients in a tertiary hospital in Indonesia. Methods: This was a descriptive cross-sectional study with a total sampling method. A prospective analysis was performed on episodes of blood transfusion in pediatric patients aged younger than 18 years old with cancer and were hospitalized at the Department of Child Health of the hospital from July to August 2019. After the consent of the parents, the patients were interviewed for various transfusion reactions. Data collected were presented using tables and charts. Results: Leukemia was the most frequent cancer in children cancer patients who need transfusion. Out of 42 children included, 155 episodes of transfusion were observed with 22 episodes showed transfusion reactions (14.2%). The most frequent manifestations were pruritus (31.8%), followed by combination of pruritus and erythema (27.4%) and fever (13.6%). These reactions appeared mostly in 1 to 2 hours (27.2%), with most were mild reactions (59.1%). Conclusion: Transfusion reactions mostly occurred among pediatric patients with cancer in the acute phase with clinical manifestation of allergic reactions, predominantly mild. Early identification of these reactions would result in better treatment and prevention for recurrence of transfusion reactions.

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Uncertainty and Nursing Needs of Parents with Pediatric Cancer Patients in Different Treatment Phases: A Cross-Sectional Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18084253 ◽

2021 ◽

Vol 18 (8) ◽

pp. 4253

Author(s):

Mijeong Park ◽

Eunyoung E. Suh ◽

Soo-Young Yu

Keyword(s):

Cancer Patients ◽

Pediatric Cancer ◽

Control Diet ◽

Treatment Phase ◽

Tertiary Hospital ◽

Cross Sectional Study ◽

Term Treatment ◽

Cross Sectional ◽

Long Term Treatment ◽

Pediatric Cancer Patients

The survival rate of pediatric cancer has increased to 80%, but long-term treatment is required. During treatment, parents experience uncertainty, which affects parents’ quality of life and, even worse, their children’s health; however, the variation of that uncertainty remains under-studied. Thus, it is crucial to understand parents’ nursing needs in each distinct treatment phase to develop relevant educational content. This study investigated the uncertainty level and nursing needs of parents according to their children’s treatment phase. This cross-sectional comparative descriptive study collected survey data from 119 people at a tertiary hospital from December 2017 to April 2018. Nursing needs were ascertained using open-ended questions, and data were analyzed using quantitative content analysis. The uncertainty levels of parents of pediatric cancer patients showed statistically significant differences across treatment phases (F = 8.209, p < 0.001). Parents’ uncertainty was higher in the treatment initiation phase (87.77 ± 13.43) and when treatment was ongoing (83.33 ± 15.10) than in the post-treatment phase (75.35 ± 12.82). All three groups had nursing needs regarding infection control, diet, daily activities of living, and prognosis. Parents’ uncertainty levels and nursing needs differed across treatment phases, suggesting a need for tailored education programs to provide practical support to parents of pediatric cancer patients in each phase.

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Central line bundle including split-septum device and single use prefilled flushing syringes for prevention of port associated bloodstream infections: A cost and resource utilization analysis

10.21203/rs.2.15266/v1 ◽

2019 ◽

Author(s):

Ilker Devrim ◽

Mustafa T Ozkul ◽

İlknur Çağlar ◽

Yeliz Oruç ◽

Nevbahar Demiray ◽

...

Keyword(s):

Line Bundle ◽

Cancer Patients ◽

Pediatric Cancer ◽

Bloodstream Infections ◽

Central Line ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Pediatric Cancer Patients ◽

Central Line Bundle

Abstract Background: Central line bundle programs were found to be effective in decreasing central line–associated bloodstream infection rates in pediatric cancer patients with ports. However cost-effectiveness studies of central line bundle programs in pediatric cancer patients are limited and most available data are from intensive care unit or adult studies. Methods: In this 6 years cross-sectional study, comprehensive assessment of total health care costs attributable to CLABSI’s associated with ports between two periods including 3 years of pre-bundle period and bundle period. Results: This cross-sectional study was carried out in the pediatric hematology-oncology ward of Dr. Behçet Uz Children’s Hospital from 1 August November 2011 to 31 July 2017. The CLABSI rates decreased significantly from 8,31 CLABSIs to 3.04 per 1000 central line days ( p <0.0001). In the prebundle period, total attributable costs spent for of patients with CLABSI were $130661,68 and in the bundle period, total attributable costs spent for patients with CLABSI were $116579,05.Within bundle implantation, 71 potential CLABSI were prevented which saved an additional $208977,81. In other words, for one dollar spent for bundle program, $ 6,54 was saved by decreasing the expected CLABSI. Conclusion: our study shows that central line bundles decreases not only the CLABSI rate, but also decreases attributable costs due to CLABSI. Expenses spent for bundle elements, were covered by savings by preventing CLABSI with higher costs

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Central line bundle including split-septum device and single-use prefilled flushing syringes for prevention of port associated bloodstream infections:A cost and resource utilization analysis

10.21203/rs.2.15266/v2 ◽

2020 ◽

Author(s):

Ilker Devrim ◽

Mustafa T Ozkul ◽

İlknur Çağlar ◽

Yeliz Oruç ◽

Nevbahar Demiray ◽

...

Keyword(s):

Line Bundle ◽

Cancer Patients ◽

Pediatric Cancer ◽

Central Line ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Pediatric Hematology ◽

Pediatric Cancer Patients ◽

Central Line Bundle

Abstract Background: Central line bundle programs were found to be effective in decreasing central line-associated bloodstream infection rates in pediatric cancer patients with ports. However, cost-effectiveness studies of central line bundle programs in pediatric cancer patients are limited, and most available data are from intensive care unit or adult studies. Methods: In this six years cross-sectional study, comprehensive assessment of total health care costs attributable to CLABSI's associated with ports between two periods. Results: This cross-sectional study was carried out in the pediatric hematology-oncology ward of Dr. Behçet Uz Children's Hospital from 1 August November 2011 to 31 July 2017. The CLABSI rates decreased significantly from 8.31 CLABSIs to 3.04 per 1000 central line days (p<0.001). In the prebundle period, total attributable costs spent for of patients with CLABSI were $130661, and in the bundle period, total attributable costs spent for patients with CLABSI were $116579. Within bundle implantation, 71 potential CLABSI were prevented, which saved an additional $208977. Conclusion: Our study shows that central line bundles decreases not only the CLABSI rate but also decreases attributable costs due to CLABSI. Expenses spent for bundle elements, were covered by savings by preventing CLABSI with higher costs

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LINC-01. COMPLIANCE TO FOLLOW UP IN PEDIATRIC PATIENTS WHO HAVE RECEIVED CRANIOSPINAL IRRADIATION

Neuro-Oncology ◽

10.1093/neuonc/noaa222.436 ◽

2020 ◽

Vol 22 (Supplement_3) ◽

pp. iii378-iii378

Author(s):

Khin Pyone ◽

Thwe Tun ◽

Yin Win ◽

Aye Thinn ◽

Khin Win ◽

...

Keyword(s):

Cancer Patients ◽

Pediatric Cancer ◽

Pediatric Patients ◽

Tertiary Hospital ◽

Craniospinal Irradiation ◽

Long Term Effects ◽

Pediatric Cancer Patients ◽

Need To Evaluate

Abstract OBJECTIVE Attendance to follow-up after completion of cancer treatment is understudied area. Pediatric cancer patients have sequelae of illness or treatment. Many have no symptom immediately after completion of treatment. Long term follow-up is important to access disease control, early diagnosis of recurrence, second cancer and treatment-related morbidities. Purpose of this study was to evaluate the compliance to follow-up in pediatric patients treated with craniospinal irradiation (CSI). METHODS This was retrospective review of follow-up in pediatric neuro-oncology patients who received (CSI) from January 2017 to June 2018 in the Radiotherapy Department of Yangon General Hospital, Myanmar. RESULT: Twenty-three patients received CSI; majority (43%) were medulloblastoma. Median age was 7.5 years (3–17 years). Only seven patients (30.4%) were attended to follow-up more than 6 months after completion of treatment. More than two-thirds of patients (n=16,69.6%) were lost to follow-up. Patients in active follow-up were diagnosed and treated at earlier age below 10years (n=5,21.7%). Demographically, 5 patients (22%) were living in the region around tertiary hospital. Sixteen patients (69.6%) from rural area had limited transportation and difficulty for accommodation in which they were treated. In socioeconomic points, 18 parents (78.2%) had poor education and financial status, lack of understanding about disease, treatment, long-term effects and follow-up. CONCLUSION Although this was limited data in CSI patients only, loss to follow-up after 6 months was high. We need to evaluate in all pediatric cancer patients and collaborate to provide financial support, childcare centres for lodging, transportation and health education to promote compliance to follow-up.

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A cross-sectional study of carnitine deficiency and fatigue in pediatric cancer patients

Child s Nervous System ◽

10.1007/s00381-015-2983-0 ◽

2016 ◽

Vol 32 (3) ◽

pp. 475-483 ◽

Cited By ~ 5

Author(s):

Jin-Shei Lai ◽

Tracy Haertling ◽

Joanna Weinstein ◽

Alfred W. Rademaker ◽

Stewart Goldman

Keyword(s):

Cancer Patients ◽

Pediatric Cancer ◽

Cross Sectional Study ◽

Carnitine Deficiency ◽

Sectional Study ◽

Cross Sectional ◽

Pediatric Cancer Patients

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Central line bundle including split-septum device and single-use prefilled flushing syringes to prevent port-associated bloodstream infections: A cost and resource-utilization analysis

10.21203/rs.2.15266/v5 ◽

2020 ◽

Author(s):

Ilker Devrim ◽

Mustafa Taha Ozkul ◽

İlknur Çağlar ◽

Yeliz Oruç ◽

Nevbahar Demiray ◽

...

Keyword(s):

Line Bundle ◽

Cancer Patients ◽

Pediatric Cancer ◽

Bloodstream Infections ◽

Central Line ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Pediatric Cancer Patients ◽

Central Line Bundle

Abstract Background: Central line bundle programs were found to be effective in decreasing central line-associated bloodstream infection rates in pediatric cancer patients with ports. However, cost-effectiveness studies of central line bundle programs in pediatric cancer patients are limited, and most available data are from intensive care unit or adult studies.Methods: In this cross-sectional study spanning 6 years, comprehensive assessment of total health care costs attributable to CLABSI's associated with ports between two periods.Results: This cross-sectional study was carried out in the pediatric hematology-oncology ward of Dr. Behçet Uz Children's Hospital from 1 August November 2011 to 31 July 2017. The CLABSI rates decreased significantly from 8.31 CLABSIs to 3.04 per 1000 central line days (p<0.001). In the pre-bundle period, total attributable costs spent for of patients with CLABSI were $130661, and in the bundle period, total attributable costs spent for patients with CLABSI were $116579. Within bundle implantation, 71 potential CLABSI were prevented, which saved an additional $208977. Conclusion: Our study shows that central line bundles decreases not only the CLABSI rate but also decreases attributable costs due to CLABSI. Expenses spent for bundle elements, were covered by savings by preventing CLABSI with higher costs

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The Contribution of Motor Changes to Oral Mucositis in Pediatric Cancer Patients: A Cross-Sectional Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16183395 ◽

2019 ◽

Vol 16 (18) ◽

pp. 3395

Author(s):

Nyellisonn N. N. Lucena ◽

Lecidamia C. L. Damascena ◽

Isabella L. A. Ribeiro ◽

Luiz M. A. Lima-Filho ◽

Ana Maria G. Valença

Keyword(s):

Children And Adolescents ◽

Cancer Patients ◽

Oral Mucositis ◽

Pediatric Cancer ◽

Body Position ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Pediatric Cancer Patients ◽

Antineoplastic Treatment

This study aimed to investigate the contribution of motor changes to oral mucositis in children and adolescents with cancer undergoing antineoplastic treatment in a referral hospital. This was an observational, cross-sectional study with 70 patients aged 2 to 19 years, diagnosed with any type of cancer and treated in a pediatric hospital cancer ward from April to September 2017. A questionnaire related to the patients’ socioeconomic and clinical conditions was used, followed by the Oral Assessment Guide and selected domains of the activity and participation section of the International Classification of Functioning, Disability, and Health tool. The data were collected by previously calibrated examiners (kappa index > 0.75) and analyzed using descriptive statistics and logistic regression (α = 5%). Children and adolescents aged 7 to 10 years were more likely to develop oral mucositis (OR: 3.62). In addition, individuals who had severe difficulty in maintaining a body position (OR: 14.45) and walking (OR: 25.42), and those diagnosed with hematologic cancers (OR: 6.40) were more likely to develop oral mucositis during antineoplastic treatment. Within the limitations of this study, it is concluded that motor changes may contribute to the occurrence of oral mucositis in pediatric cancer patients.

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Central line bundle including split-septum device and single-use prefilled flushing syringes to prevent port-associated bloodstream infections: A cost and resource-utilization analysis

10.21203/rs.2.15266/v4 ◽

2020 ◽

Author(s):

Ilker Devrim ◽

Mustafa Taha Ozkul ◽

İlknur Çağlar ◽

Yeliz Oruç ◽

Nevbahar Demiray ◽

...

Keyword(s):

Line Bundle ◽

Cancer Patients ◽

Pediatric Cancer ◽

Bloodstream Infections ◽

Central Line ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Pediatric Cancer Patients ◽

Central Line Bundle

Abstract Background: Central line bundle programs were found to be effective in decreasing central line-associated bloodstream infection rates in pediatric cancer patients with ports. However, cost-effectiveness studies of central line bundle programs in pediatric cancer patients are limited, and most available data are from intensive care unit or adult studies.Methods: In this cross-sectional study spanning 6 years, comprehensive assessment of total health care costs attributable to CLABSI's associated with ports between two periods.Results: This cross-sectional study was carried out in the pediatric hematology-oncology ward of Dr. Behçet Uz Children's Hospital from 1 August November 2011 to 31 July 2017. The CLABSI rates decreased significantly from 8.31 CLABSIs to 3.04 per 1000 central line days (p<0.001). In the pre-bundle period, total attributable costs spent for of patients with CLABSI were $130661, and in the bundle period, total attributable costs spent for patients with CLABSI were $116579. Within bundle implantation, 71 potential CLABSI were prevented, which saved an additional $208977. Conclusion: Our study shows that central line bundles decreases not only the CLABSI rate but also decreases attributable costs due to CLABSI. Expenses spent for bundle elements, were covered by savings by preventing CLABSI with higher costs

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Improving the rate of influenza vaccination in pediatric patients with cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.31_suppl.49 ◽

2013 ◽

Vol 31 (31_suppl) ◽

pp. 49-49

Author(s):

Jason Lawrence Freedman ◽

Anne F. Reilly ◽

L. Charles Bailey

Keyword(s):

Influenza Vaccine ◽

Influenza Vaccination ◽

Cancer Patients ◽

Pediatric Cancer ◽

Pediatric Patients ◽

Provider Education ◽

Clinical Process ◽

Patients With Cancer ◽

Increased Risk ◽

Pediatric Cancer Patients

49 Background: Pediatric patients with cancer are at increased risk of influenza, with high mortality, morbidity, and delay of cancer therapy. CDC guidelines support yearly vaccination in these patients. In prior years at our center, only 53-56% of pediatric cancer patients received at least one dose of the vaccine. Our objective was to increase the rates of influenza vaccination in pediatric cancer patients through a multi-faceted QI initiative. Methods: Five interventions were instituted concomitantly, in eligible patients (>6 months old, >100 days from BMT if applicable, and within 1 year of chemotherapy) over a 6-month period (9/1/12 to 3/31/13). 1) Family education: provision of influenza/vaccine handouts to families in clinic waiting rooms; 2) Health informatics intervention: via electronic health records, generation of daily lists of patients due for doses with automated email lists to triage and nurses; 3) Clinical process interventions: standardization of triage process to identify patients needing vaccination and provision of colored wristbands to such patients alerting providers to order the vaccine, or document refusals, during the encounter; 4) Inpatient orders: influenza vaccine order built into computerized physician admission order set to trigger vaccination upon discharge; and 5) Provider education: printed materials and tutorials for staff at conferences on proper screening of patients, vaccine ordering/dose, and correct documenting of refusals/contraindications. These processes were iteratively refined over the 6-month timeframe. Results: Influenza immunization rates increased by 20% after the changes were implemented; this was seen across all tumor subgroups. Overall, 74% of patients received at least one dose as compared with 52% in the prior year. 61% of patients were fully immunized (vs. 42% in 2011-12). Immunizations were deferred due to allergy/refusal in 8% of patients (vs. 7% in 2011-12). Consequently, only 18% of eligible patients were unimmunized as compared to 41% in the prior year. Conclusions: Technology, education, and clinical process changes led to a successful increase in influenza vaccination rates. Ongoing efforts will target subgroups with lowest overall rates of immunization.

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