Pain Management in Childhood Leukemia: Diagnosis and Available Analgesic Treatments.
Pain Management in Childhood Leukemia: Diagnosis and Available Analgesic Treatments.
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DOI：
10.3390/cancers12123671
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发表时间：
2020-12-07
期刊：
影响因子：
5.2
通讯作者：
Milano F
中科院分区：
文献类型：
--
作者：
Coluzzi F;Rocco M;Green Gladden R;Persiani P;Thur LA;Milano F
白血病是儿童癌症中最常见的一种，在所有影响儿童和年轻人的癌症中，白血病约占30%。虽然疼痛是儿童白血病的一种常见且令人痛苦的症状，但缺乏关于评估和管理的循证指导。我们与6名国际多学科医疗保健专业人员一起，旨在回顾当前文献中的证据，讨论儿童最常见的白血病相关疼痛综合征的诊断、评估和药物治疗，包括与癌症相关的疼痛神经病变和骨坏死。我们还关注疼痛对儿童白血病患者生活质量的影响，以及儿科人群中使用的最常见的止痛药，不同国家的使用情况不同。疼痛是白血病儿童最常见的症状之一，他们经常被误诊为其他童年疼痛疾病，如幼年特发性关节炎。激素诱导的骨坏死(ON)和长春新碱诱导的周围神经病变(VIPN)是最常见的疼痛表现。此外，持续性疼痛可能会继续影响生存质量。这篇叙述性的综述集中在儿童白血病疼痛的病理生理学机制和目前可用的止痛治疗适应症。儿童的疼痛管理往往不充分，因为疼痛评估困难，各国的适应症不同，以及缺乏具体的儿科试验。止痛药通常是通过从成人指南中推断信息而在标签外给儿童开的，可能会增加不良事件的风险。最佳的疼痛管理应该包括一个多学科团队，以确保针对个别患者量身定制的评估和干预措施。
Leukemia, the most common form of childhood cancer, accounts for about 30 percent of all cancers that affect children and young adults. Although pain is a common and distressing symptom of childhood leukemia, evidence-based guidance regarding assessment and management is lacking. With 6 international multidisciplinary healthcare professionals, we aimed to review current evidence in literature, addressing diagnosis, assessment and pharmacological management of the most common leukemia-related pain syndromes in children, including cancer-related painful neuropathies and osteonecrosis. We also focus on the impact of pain on quality of life of childhood leukemia patients and the most common pain medications used in the pediatric population, with differences in their utilizations across countries. Pain is one of the most common symptoms in children suffering from leukemia, who are often misdiagnosed with other childhood painful diseases such as juvenile idiopathic arthritis. Corticosteroid-induced osteonecrosis (ON) and vincristine-induced peripheral neuropathy (VIPN) are the most common painful manifestations. Additionally, ongoing pain may continue to impact quality of life in survivorship. This narrative review focuses on the pathophysiological mechanisms of pain in childhood leukemia and current available indications for analgesic treatments. Pain management in children is often inadequate because of difficulties in pain assessment, different indications across countries, and the lack of specific pediatric trials. Analgesic drugs are often prescribed off-label to children by extrapolating information from adult guidelines, with possible increased risk of adverse events. Optimal pain management should involve a multidisciplinary team to ensure assessment and interventions tailored to the individual patient.
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影响因子：
6.2
作者：
D'Agostino, Norma Mammone;Edelstein, Kim;Zhang, Nan;Recklitis, Christopher J.;Brinkman, Tara M.;Srivastava, Deokumar;Leisenring, Wendy M.;Robison, Leslie L.;Armstrong, Gregory T.;Krull, Kevin R.
通讯作者：
Krull, Kevin R.
Tapentadol延长了多发性骨髓瘤患者的释放，患有中度到重度癌症由于骨骼疾病。
影响因子：
2.7
作者：
Coluzzi F;Raffa RB;Pergolizzi J;Rocco A;Locarini P;Cenfra N;Cimino G;Mattia C
通讯作者：
Mattia C
影响因子：
3.4
作者：
de Rojas, T.;Martinez-Alvarez, S.;Ramirez, M.
通讯作者：
Ramirez, M.
影响因子：
3.2
作者：
DeFeo, Brian M.;Kaste, Sue C.;Ness, Kirsten K.
通讯作者：
Ness, Kirsten K.
影响因子：
6.2
作者：
Dupuis, L. Lee;Lu, Xiaomin;Kadan-Lottick, Nina S.
通讯作者：
Kadan-Lottick, Nina S.