ABSTRACT
Abstract Background Increased malignancy frequency is well documented in adult-systemic lupus erythematosus (SLE), but with limited reports in childhood-onset SLE (cSLE) series. We explored the frequency of malignancy associated with cSLE, describing clinical and demographic characteristics, disease activity and cumulative damage, by the time of malignancy diagnosis. Method A retrospective case-notes review, in a nationwide cohort from 27 Pediatric Rheumatology centres, with descriptive biopsy-proven malignancy, disease activity/damage accrual, and immunosuppressive treatment were compiled in each participating centre, using a standard protocol. Results Of the 1757 cSLE cases in the updated cohort, 12 (0.7%) developed malignancy with median time 10 years after cSLE diagnosis. There were 91% females, median age at cSLE diagnosis 12 years, median age at malignancy diagnosis 23 years. Of all diagnosed malignancies, 11 were single-site, and a single case with concomitant multiple sites; four had haematological (0.22%) and 8 solid malignancy (0.45%). Median (min-max) SLEDAI-2 K scores were 9 (0-38), median (min-max) SLICC/ACR-DI (SDI) score were 1 (1-5) Histopathology defined 1 Hodgkin's lymphoma, 2 non-Hodgkin's lymphoma, 1 acute lymphoblastic leukaemia; 4 gastrointestinal carcinoma, 1 squamous cell carcinoma of the tongue and 1 anal carcinoma; 1 had sigmoid adenocarcinoma and 1 stomach carcinoid; 3 had genital malignancy, being 1 vulvae, 1 cervix and 1 vulvae and cervix carcinomas; 1 had central nervous system oligodendroglioma; and 1 testicle germ cell teratoma. Conclusion Estimated malignancy frequency of 0.7% was reported during cSLE follow up in a multicentric series. Median disease activity and cumulative damage scores, by the time of malignancy diagnoses, were high; considering that reported in adult series.
ABSTRACT
Objective: The objective of this study was to study the demographic data and clinical outcome of cancer patient admitted inintensive care unit (ICU).Materials and Methods: Data of cancer patients admitted in ICU of tertiary care hospital between August 2017 and September2018 were reviewed retrospectively.Results: During the study period, 441 cancer patients were admitted in ICU. Majority of patients were male (58.27%). The mostcommon reason for ICU referral was respiratory problem (31.75%) followed by cardiovascular (26%). Lung carcinoma wasthe most common among solid malignancy, whereas lymphoma was the most common hematological malignancy. Patientswith hematological malignancy were relatively younger (55 years vs. 63 years). Patients who required inotropes/vasopressorsor mechanical ventilation had poor prognosis than the others. The mortality rate was higher in patient with hematologicalmalignancy than solid malignancy patients.Conclusion: The demand for intensive care for critically ill cancer is increasing, and considering the improvement in prognosiscancer patients should not be denied ICU care merely on the basis of a patient suffering from cancer. Data suggest that admittingselected patient with cancer to ICU is justifiable, but mere admitting patents for end of life care is not recommended.