Ye.B. Kurakbayev^1,2, B.S. Turdaliyeva^1,3, K.O. Umbetov², Ye.S. Sarsekbayev²

1. «Kazakhstan Medical University «Kazakhstan School of Public Health» LLP, Almaty, the Republic of Kazakhstan;
2. «Scientific Center of Pediatrics and Pediatric Surgery» JSC, Almaty, the Republic of Kazakhstan;
3. «Kazakh Scientific Center of Dermatology and Infectious Diseases» RSE on PVC, Almaty, the Republic of Kazakhstan

DOI: https://www.doi.org/10.52532/2521-6414-2023-4-70-46-50

UDC: 616.155.392:614.253.81

Year: 2023 issure: 70 number: 4 pages: 46-50

Download PDF:

ABSTRACT

Relevance: Acute lymphoblastic leukemia (ALL) is a common malignancy in children. Approximately 85% of ALLs have B-cell origin, and 15% are T-cell ALLs. Many patients diagnosed with hematologic cancer will require hospitalization in the intensive care unit (ICU) at some point in their treatment.
The aim was to study the available literature on clinical deterioration in patients with АLL admitted to the ICU, the clinical significance and prognostic value of causes of clinical deterioration, and adverse outcomes in patients with АLL staying in the ICU.
Methods: A descriptive cross-sectional study approach was used. We reviewed published sources from 2016 to 2023 to collect data on major reasons for ALL patients’ hospitalization to ICU.
Results: First, the patient’s age at the time of initial diagnosis of ALL is crucial. Cure rates for B-cell ALL are higher between 1 and 9 years of age than in other age groups. Second, the initial white blood cell count during diagnosis is a prognostic indicator. Third, the specific subtype of ALL also affects prognosis. The risk factors emphasize the importance of comorbidities and infectious diseases, as well as monitoring and managing pulmonary and cardiovascular function in patients to avoid hospitalization in the ICU. The main causes of hospitalization in the ICU are complications related to chemotherapy, infection, and unplanned hospitalizations. Compared to normal-risk patients, high-risk patients had a higher rate of OIT hospitalization in the ICU. It is important to control chemotherapy and infections to reduce the number of admissions to the ICU in this group.
Conclusion: Chemotherapy, concomitant and infectious diseases, hypoxia, and hemodynamic instability are reasons for hospitalization of these patients to ICU. The condition of various organs and systems shall be monitored.
Keywords: children, clinical deterioration, intensive care unit, acute lymphoblastic leukemia (ALL), critical conditions.

List of sources used:

1. Шервашидзе М.А., Валиев Т.Т. Совершенствование программ терапии острого лимфобластного лейкоза у детей: акцент на минимальную остаточную болезнь // Онкогематология. – 2020. – №15(3). – С.12-26 [Shervashidze M.A., Valiev T.T. Sovershenstvovanie programm terapii ostrogo limfoblastnogo lejkoza u detej: akcent na minimal’nuyu ostatochnuyu bolezn’ // Onkogematologiya. – 2020. – №15(3). – S.12-26 (in Russ.)] https://doi.org/10.17650/1818-8346-2020-15-3-12-26
2. Куракбаев Е.Б., Турдалиева Б.С., Манжуова Л.Н., Омарова К.О., Абдилова Г.К., Кусаинов А.З., Сапарбаев С.С., Щукин В.В. Международный опыт применения системы педиатрических признаков раннего предупреждения критических состояний у онкологических детей: обзор литературы // Онкология и Радиология Казахстана. – 2023. – №2 (68). – С. 69-75 [Kurakbaev E.B., Turdalieva B.S., Manzhuova L.N., Omarova K.O., Abdilova G.K., Kusainov A.Z., Saparbaev S.S., Shhukin V.V. Mezhdunarodnyj opyt primenenija sistemy pediatricheskih priznakov rannego preduprezhdenija kriticheskih sostojanij u onkologicheskih detej: obzor literatury // Onkologija i Radiologija Kazahstana. – 2023. – №2 (68). – S. 69-75 (in Russ.)]. https://www.doi.org/10.52532/2521-6414-2023-2-68-69-75
3. Kurakbayev Ye.B., Turdaliyeva B.S., Manzhuova L.N., Sсhukin V.V. Risk factors and early signs of critical conditions in children with acute lympho-blastic leukemia admitted to the intensive care unit // Онкология и Радиология Казахстана. – 2023. – №3 (69). – S. 38-46. https://www.doi.org/10.52532/2521-6414-2023-3-69-38-46
4. Ahmad I., Ghafoor T., Ullah A., Naz S., Tahir M., Ahmed S., Arshad A., Ali A., Khattack T.A., Batool F. Pediatric Acute Lymphoblastic Leukemia: Clinical Characteristics, Treatment Outcomes, and Prognostic Factors: 10 Years’ Experience From a Low- and Middle-Income Country // JCO Glob Oncol. – 2023. – Vol. 9. – Art. no. 2200288. https://doi.org/10.1200/GO.22.00288
5. Vijenthira A., Chiu N., Jacobson D., Freedman Z., Cheung M.C., Goddard S., Fowler R., Buckstein R. Predictors of intensive care unit admission in patients with hematologic malignancy // Sci. Rep. – 2020. – Vol. 10(1) – Art. no. 21145. https://doi.org/10.1038/s41598-020-78114-7
6. Безнос О.А., Гривцова Л.Ю., Попа А.В., Шервашидзе М.А., Серебрякова И.Н, Баранова О.Ю., Османов Е.А., Тупицын Н.Н. Определение минимальной остаточной болезни при В-линейных острых лимфобластных лейкозах с использованием подходов EuroFlow // Клин. онкогематол. – 2017. – № 10 (2). – С. 158-168 [Beznos O.A., Grivcova L.Yu., Popa A.V., Shervashidze M.A., Serebryakova I.N, Baranova O.Yu., Osmanov E.A., Tupicyn N.N. Opredelenie minimal’noj ostatochnoj bolezni pri V-linejnyx ostryx limfoblastnyx lejkozax s ispol’zovaniem podxodov EuroFlow // Klin. onkogematol. – 2017. – № 10 (2). – S.158-168 (in Russ.)]. https://doi.org/10.21320/2500-2139-2017-10-2-158-168
7. Чернышева О.А., Гривцова Л.Ю., Серебрякова И.Н., Купрышина Н.А., Шолохова Е.Н., Шервашидзе М.А., Палладина А.Д., Курдюков Б.В., Попа А.В., Тупицын Н.Н. Диагностика острых лимфобластных лейкозов из Т-линейных предшественников и подходы к мониторингу минимальной остаточной болезни // Клин. онкогематол. – 2019. – № 12(1). – С. 79-85 [Chernysheva O.A., Grivcova L.Yu., Serebryakova I.N., Kupryshina N.A., Sholoxova E.N., Shervashidze M.A., Palladina A.D., Kurdyukov B.V., Popa A.V., Tupicyn N.N. Diagnostika ostryx limfoblastnyx lejkozov iz T-linejnyx predshestvennikov i podxody k monitoringu minimal’noj ostatochnoj bolezni // Klin. onkogematol. – 2019. – № 12(1). –S.79–85]. https://doi.org/10.21320/2500-2139-2019-12-1-79-85
8. Беляева А.С., Ванько Л.В., Матвеева Н.К. Нейтрофильные гранулоциты, как регуляторы иммунитета. // Иммунология. – 2016. – № 37(2). – С. 129-133 [Belyaeva A.S., Van’ko L.V., Matveeva N.K. Nejtrofil’nye granulocity, kak regulyatory immuniteta. // Immunologiya. – 2016. – № 37(2). – S. 129-133 (in Russ.)]. https://doi.org/10.18821/0206-4952-2016-37-2-129-133
9. Валиев Т.Т. Лимфома Беркитта у детей: 30 лет терапии. // Педиатрия. – Ж. им. Г.Н. Сперанского. – 2020. – № 99(4). – С. 35–41 [Valiev T.T. Limfoma Berkitta u detej: 30 let terapii. // Pediatriya. – Zh. im. G.N. Speranskogo. – 2020. – № 99(4). – S. 35–41 (in Russ.)]. https://doi.org/10.24110/0031-403X-2020-99-4-35-42
10. American Cancer Society. Prognostic Factors in Childhood Leukemia (ALL or AML) . 30.11.2023.
11. Ranta S., Broman L.M., Abrahamsson J., Berner J., Fläring U., Hed Myrberg I., Kalzén H., Karlsson L., Mellgren K., Nilsson A., Norén-Nyström U., Palle J., von Schewelov K., Svahn J.E., Törnudd L., Heyman M., Harila-Saari A. ICU Admission in Children With Acute Lymphoblastic Leukemia in Sweden: Prevalence, Outcome, and Risk Factors // Pediatr Crit. Care. Med. – 2021. – Vol. 22(12). – P. 1050-1060. https://doi.org/10.1097/PCC.0000000000002787
12. Leahy A.B., Elgarten C.W., Li.Y., Huang Y.V., Fisher B.T., Delp D., Aplenc R., Getz K.D. Evaluation of Hospital Admission Patterns in Children Receiving Treatment for Acute Lymphoblastic Leukemia: What Does a Typical Leukemia Experience Look like? // Blood. – 2018. – Vol. 132(S1). – Art. no. 4763. https://doi.org/10.1182/blood-2018-99-119970
13. Rheingold S.R., Ji L., Xu X., Devidas M., Brown P.A., Gore L., Winick N.J., Carroll W.L., Hunger S., Raetz E.A., Loh M.L., BhojwaniD. Prognostic factors for survival after relapsed acute lymphoblastic leukemia (ALL): A Children’s Oncology Group (COG) study // Clinical Oncology – 2019. – Vol. 37(17). – Art. no. 10008. https://doi.org/10.1200/JCO.2019.37.15_suppl.10008
14. Ahmad I., Ghafoor T., Ullah A., Naz S., Tahir M., Ahmed S., Arshad A., Ali A., Khattack T.A., Batool F. Pediatric Acute Lymphoblastic Leukemia: Clinical Characteristics, Treatment Outcomes, and Prognostic Factors: 10 Years’ Experience From a Low- and Middle-Income Country // JCO Glob Oncol. – 2023. – Vol. 9. – Art. no. e2200288. https://doi.org/10.1200/GO.22.00288
15. Roberts K.G. Genetics and prognosis of ALL in children vs adults // Hematology Am. Soc. Hematol. Educ. Program – 2018. – Vol. 2018 (1). – P. 137-145. https://doi.org/10.1182/asheducation-2018.1.137
16. Dendir G., Awoke N., Alemu A., Sintayhu A., Eanga S., Teshome M., Zerfu M., Tila M., Dessu B.K., Efa A.G., Gashaw A. Factors Associated with the Outcome of a Pediatric Patients Admitted to Intensive Care Unit in Resource-Limited Setup: Cross-Sectional Study // Pediatric Health Med. Ther. – 2023. – Vol. 14. – P. 71-79. https://doi.org/10.2147/PHMT.S389404
17. Ungar S.P., Solomon S., Stachel A., Shust G.F., Clouser K.N., Bhavsar S.M., Lighter J. Hospital and ICU Admission Risk Associated With Comorbidities Among Children With COVID-19 Ancestral Strains // Clin. Pediatr. (Phila) – 2023. – Vol. 62 (9). – P. 1048-1058. https://doi.org/10.1177/00099228221150605
18. The Ottawa Hospital. ICU Medical Conditions . 30.11.2023
19. Society of Critical Care Medicine. Critical Care Statistics https://sccm.org/Communications/Critical-Care-Statistics. 30.11.2023
20. Kalicińska E., Kuszczak B., Dębski J., Szukalski Ł., Wątek M., Strzała J., Rybka J., Czyż J., Lech-Marańda E., Zaucha J., Wróbel T. Hematological malignancies in Polish population: what are the predictors of outcome in patients admitted to Intensive Care Unit? // Support. Care Cancer. – 2020. – Vol. 29. – P. 323-330. https://doi.org/10.1007/s00520-020-05480-3
21. Vijenthira A., Chiu N., Jacobson D., Freedman Z., Cheung M.C., Goddard S., Fowler R., Buckstein R. Predictors of intensive care unit admission in patients with hematologic malignancy // Sci. Rep. – 2020. – Vol. 10(1). – Art. no.21145. https://doi.org/10.1038/s41598-020-78114-7
22. Maeng C.V. Christiansen C.F., Liu K.D., Kamper P., Christensen S., Medeiros B.C., Østgård L.S.G. Factors associated with risk and prognosis of intensive care unit admission in patients with acute leukemia: a Danish nationwide cohort study // Leuk. Lymphoma. – 2022. – Vol. 63 (10). – P.2290-2300. https://doi.org/10.1080/10428194.2022.2074984
23. McLaughlin K., Stojcevski A., Hussein A., Moudgil D., Woldie I., Hamm C. Patient vital signs in relation to ICU admission in treatment of acute leukemia: a retrospective chart review // Hematology. – 2021. – Vol. 26 (1). – P. 637-647. https://doi.org/10.1080/16078454.2021.1966223