Enhancing Supportive and Palliative Care Services for Children with Hematologic Malignancies

Introduction: Hematologic malignancies account for over ۴۰% of children's cancers, with leukemia being the most prevalent malignancy among them. Children with cancer and their families face numerous challenges related to managing physical, psychological, and emotional problems, as well as end-of-life decisions. Therefore, integrating palliative support services into the treatment plan for cancer patients can enhance their quality of life and alleviate the suffering of ill children and their families.Method: The medical records of patients with hematological malignancies who were referred to the MACSA Pediatric Palliative Care Department at Mofid Children's Hospital from December ۲۲, ۲۰۲۳, to May ۱۶, ۲۰۲۴, were reviewed, and the reasons for their referral were analyzed.Results: In general, out of the total of ۱۲۳ patients referred to the pediatric palliative care department, ۴۶ patients were diagnosed with hematologic malignancies, which constitute ۳۷.۳۹% of all referred patients. A total of ۵۵ visits were made in the palliative care department. Patients with acute lymphoblastic leukemia (ALL) had the largest number (۶۰%). ۳۲ patients were referred to the PPC ward from the pediatric hematology and oncology outpatient clinic, and ۲۳ patients were referred from the hospital emergency department. The most common reasons for PPC referral were fever (۳۰.۹۸%), pancytopenia in tests (۱۹.۷۱%), cough and weakness (۹.۸۵%). The primary measures taken for the patients included managing physical symptoms and controlling fever (in ۴۳ patients), administering blood products (for ۳۳ patients), and providing family support (for ۱۷ patients).Conclusion: Fever and pancytopenia, as the two main reasons for referring patients with hematologic malignancies to the palliative care department, should be given special attention. Preventing infections, providing routine care, and scheduling shorter follow-up intervals can decrease the occurrence of these symptoms. Consequently, this can reduce the necessity for hospitalization in the palliative ward, allowing for more palliative supportive care to be administered on an outpatient basis for the patient.

کلیدواژه ها:

Palliative care ، Hematologic Neoplasm ، leukemia