Therapeutics for paediatric oncological emergencies

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Background: With advancements in the field of oncology, cancer survival rates have improved dramatically but modern cancer treatments also come with an increasing number of disease and treatment-associated complications. This article provides an updated narrative review on the pathophysiology, clinical presentations and latest management strategies for common paediatric oncological emergencies.

Methods: An extensive PubMed® search of all human studies in the English literature was performed in Clinical Queries for different oncology syndromes and conditions using the following Medical Subject Headings: “tumour lysis syndrome”, “hyperleukocytosis”, “disseminated intravascular coagulation”, “superior mediastinal syndrome”, “superior vena cava syndrome”, “sepsis”, “severe inflammatory response syndrome”, “acute respiratory distress syndrome”, “posterior reversible encephalopathy syndrome” and “reversible posterior leukoencephalopathy syndrome”. Categories were limited to clinical trials and reviews for ages from birth to 18 years.

Results: The general description, presentation and management of these oncologic emergencies are systematically described. Early recognition along with prompt and proactive treatment can reduce the chances of potential complications and improve the clinical outcomes, thereby improving not only survival rates in oncology patients but also their clinical outcomes and quality of life.

Conclusions: Oncologic emergencies are associated with significant mortality and morbidity. Healthcare professionals involved with the care of oncology patients must be vigilant of these emergencies.

Keywords: acute respiratory distress syndrome (ARDS), Cancer, critical care, disseminated intravascular coagulation, hyperleukocytosis, oncologic emergency, paediatrics, posterior reversible encephalopathy syndrome (PRES), sepsis, superior mediastinal syndrome, therapeutics, treatment, tumour lysis syndrome.

Citation: Leung KKY, Hon KL, Hui WF, Leung AKC, Li CK. Therapeutics for paediatric oncological emergencies. Drugs in Context 2021; 10: 2020-11-5. DOI: 10.7573/dic.2020-11-5

Contributions: KKYL is the principal author. KLH, WFH and AKCL are coauthors who contributed and helped with the drafting of this manuscript. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole and have given their approval for this version to be published.

Disclosure and potential conflicts of interest: KLH and AKCL are associate editors of Drugs in Context and confirm that this article has no other conflicts of interest otherwise. This manuscript was sent out for independent peer review by the Managing Editor. The authors declare that they have no conflicts of interest relevant to this manuscript. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors is available for download at:

Acknowledgements: None.

Funding declaration: There was no funding associated with the preparation of this article.

Copyright: Copyright © 2021 Leung KKY, Hon KL, Hui WF, Leung AKC, Li CK. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0 which allows anyone to copy, distribute and transmit the article provided it is properly attributed in the manner specified below. No commercial use without permission.

Correct attribution: Copyright © 2021 Leung KKY, Hon KL, Hui WF, Leung AKC, Li CK. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0.

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Correspondence: Kam Lun Ellis Hon, Doctor’s Office, 9/F, Tower B, Hong Kong Children’s Hospital, 1 Shing Cheong Road, Kowloon Bay, Kowloon, Hong Kong SAR, China. Email:

Provenance: Invited; externally peer-reviewed.

Submitted: 19 November 2020; Accepted: 20 April 2021; Publication date: 23 June 2021.

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