Pediatric Hematology/Oncology and ImmunopathologyPediatric Hematology/Oncology and ImmunopathologyВопросы гематологии/онкологии и иммунопатологии в педиатрии1726-17082414-9314Fund Doctors, Innovations, Science for Children49610.24287/1726-1708-2021-20-1-180-183LITERATURE REVIEWОБЗОР ЛИТЕРАТУРЫCauses of transfer and mortality in children with oncohematological diseases admitted to the intensive care unitПричины перевода и смертности у детей с онкогематологическими заболеваниями, поступивших в отделение интенсивной терапииhttps://orcid.org/0000-0003-0524-498XAliyevaF. S.АлиеваФ. С.
Kazakhstan

a pediatric oncologist, a hematologist, a graduate student at the Department of Children’s Diseases №2,

49A Beybitshilik St., Nur-Sultan, 010000

врач-детский онколог, врач-гематолог, магистрант кафедры детских болезней №2,

010000, Нур-Султан, ул. Бейбитшилик, 49A

saytsilinovna@gmail.comhttps://orcid.org/0000-0002-8389-2061MuldahmetovM. S.МулдахметовМ. С.
Kazakhstan

Nur-Sultan

Нур-Султан

https://orcid.org/0000-0003-3210-3760NurmagambetovaB. K.НурмагамбетоваБ. К.
Kazakhstan

Nur-Sultan

Нур-Султан

Astana Medical UniversityНАО «Медицинский университет Астана»National Research Center for Maternal and Child Health of the University Medical Center (UMC)КФ “UMC” Национальный научный центр материнства и детства210420212011801832104202121042021Copyright ©; 2021, «D. Rogachev NMRCPHOI»Copyright ©; 2021, ФГБУ «НМИЦ ДГОИ им. Дмитрия Рогачева» Минздрава России2021«D. Rogachev NMRCPHOI»ФГБУ «НМИЦ ДГОИ им. Дмитрия Рогачева» Минздрава Россииhttps://creativecommons.org/licenses/by/4.0https://hemoncim.com/jour/article/view/496

The last few decades survival rates of children with hematologic malignancies have improved significantly, due to a potentially curative chemotherapy protocols, the expansion of biological knowledge and innovative methods of therapy. However oncohematological pediatric patients are at high risk for rapid clinical deterioration due to numerous factors such as the severity of the underlying condition, interventions toxicity and associated immunosuppression. Using aggressive tactics of therapy with oncohematological diseases in children is also associated with complications and life-threatening events that lead to admission to the pediatric intensive care unit. Historically, these children have been considered as poor candidates for intensive care. Discussions around the transfer of children with hematological malignancies to intensive care units and also the expected prognosis raised complicate and delicate questions, especially from an ethical point of view. Despite the general tendency of improved survival rate, mortality in the intensive care unit on hematological malignancies children, unfortunately, is still high and, in comparison to adults, has remained relatively invariable over the past decades. These findings highlight the necessity for research in this group of patients. 

За последние несколько десятилетий показатели выживаемости детей с онкогематологическими заболеваниями значительно улучшились благодаря потенциально излечивающим протоколам химиотерапии, расширению биологических знаний и инновационным методам лечения. Однако педиатрические онкогематологические пациенты относятся к группе высокого риска по быстрому клиническому ухудшению вследствие множества факторов, таких как тяжесть основного состояния, токсичность вмешательств и связанная с ними иммуносупрессия. Использование агрессивной тактики терапии онкогематологических заболеваний у детей также связано с осложнениями и опасными для жизни событиями, которые приводят к поступлению в педиатрические отделения реанимации и интенсивной терапии. Исторически эти дети считались плохими кандидатами на интенсивную терапию. Дискуссии вокруг перевода детей с онкогематологическими заболеваниями в отделения реанимации и интенсивной терапии и ожидаемый прогноз, вызывали сложные и деликатные вопросы, особенно с этической точки зрения. Несмотря на общую тенденцию к улучшению выживаемости, смертность в отделениях реанимации и интенсивной терапии среди детей с онкогематологическими заболеваниями, к сожалению, высока и в отличие от взрослых пациентов остается относительно неизменной в течение последних десятилетий. Эти данные подчеркивают необходимость исследований в этой группе пациентов. 

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