International expert consensus statement on PICU admission and early critical care management for paediatric patients following haematopoietic cell transplant and immune effector cell therapy

IF 19.9 1区医学 Q1 PEDIATRICS

Lancet Child & Adolescent Health Pub Date : 2025-05-14 DOI:10.1016/S2352-4642(25)00091-4

Prof Matteo Di Nardo MD , Prof Saad Ghafoor MD , Prof Zofia Szmit MD , Prof Lama Elbahlawan MD , Prof Courtney M Rowan MD , Prof Asya Agulnik MD , Prof Roelie Wosten-Van Asperen MD , Prof Matthew S Zinter MD , Prof Marianne E Nellis MD , Prof Karen Moody MD , Prof Orsola Gawronski PhD , Prof Daniele G Biasucci MD , Beatrice Baldelli MD , Prof Krzysztof Kalwak MD , Fabiana Cacace MD , Manuela Moncada MSc , Prof Kris M Mahadeo MD

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引用次数: 0

Abstract

Advances in paediatric haematopoietic cell transplantation strategies using immune-effector cells (HCT-IEC) and in intensive care management have improved survival expectations for patients with malignant and non-malignant diseases. However, critical illness still complicates the clinical course for 10–35% of patients undergoing HCT-IEC because of disease-related complications or treatment-related toxicities. Given the improvement in survival for these patients in paediatric intensive care units (PICU), the European Society of Paediatric and Neonatal Intensive Care (ESPNIC), the HCT-Cancer Immunotherapy Subgroup of the Paediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network, and the Paediatric Diseases Working Party of the European Society for Blood and Marrow Transplantation (EBMT) derived expert consensus statements to guide PICU admission and early critical care management of patients following HCT-IEC. 27 statements were drafted by the steering committee and subsequently voted on by 20 expert panel members with expertise in HCT and IEC. 20 statements received strong agreement and seven received weak agreement. This consensus statement serves as a guide for intensivists, haematologists, and oncologists during the challenging process of PICU admission and critical care management of patients who have undergone HCT-IEC and can serve as a basis for prioritising future research in the field.

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儿童造血细胞移植和免疫效应细胞治疗后PICU入院和早期重症监护管理的国际专家共识声明

使用免疫效应细胞（HCT-IEC）的儿科造血细胞移植策略和重症监护管理的进展提高了恶性和非恶性疾病患者的生存预期。然而，由于疾病相关的并发症或治疗相关的毒性，10-35%的HCT-IEC患者的危重疾病仍使临床过程复杂化。鉴于这些患者在儿科重症监护病房（PICU）生存率的提高，欧洲儿科和新生儿重症监护学会（ESPNIC）、儿科急性肺损伤和败血症调查员网络（PALISI）的hct -癌症免疫治疗亚组，欧洲血液和骨髓移植协会（EBMT）的儿科疾病工作组得出了专家共识声明，以指导PICU入院和HCT-IEC后患者的早期重症监护管理。指导委员会起草了27份声明，随后由20名具有卫生技术和信息教育专业知识的专家小组成员投票表决。20项声明得到强烈同意，7项声明得到较弱同意。这一共识声明可作为重症医师、血液科医生和肿瘤科医生在PICU入院和接受HCT-IEC患者重症监护管理的挑战性过程中的指南，并可作为该领域未来研究优先级的基础。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Lancet Child & Adolescent Health Psychology-Developmental and Educational Psychology

CiteScore

40.90

自引率

0.80%

发文量

381

期刊介绍： The Lancet Child & Adolescent Health, an independent journal with a global perspective and strong clinical focus, presents influential original research, authoritative reviews, and insightful opinion pieces to promote the health of children from fetal development through young adulthood. This journal invite submissions that will directly impact clinical practice or child health across the disciplines of general paediatrics, adolescent medicine, or child development, and across all paediatric subspecialties including (but not limited to) allergy and immunology, cardiology, critical care, endocrinology, fetal and neonatal medicine, gastroenterology, haematology, hepatology and nutrition, infectious diseases, neurology, oncology, psychiatry, respiratory medicine, and surgery. Content includes articles, reviews, viewpoints, clinical pictures, comments, and correspondence, along with series and commissions aimed at driving positive change in clinical practice and health policy in child and adolescent health.