Departments of Pediatrics.
Neurology.
J Pediatr Hematol Oncol. 2023 Aug 1;45(6):291-300. doi: 10.1097/MPH.0000000000002622. Epub 2023 Jan 12.
Pediatric cancer patients have an increased risk of stroke. However, there is a knowledge gap regarding stroke in early stages of pediatric cancer. The objective of this project is to describe the current knowledge on stroke in pediatric cancer patients.
Systematic review.
After Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines, literature search was conducted in PubMed, Cochrane, and Google Scholar from January 1, 1995, up to February 1, 2022.
A total of 3499 studies were identified, of which 8 met inclusion criteria. The incidence of stroke in pediatric cancer patients varied between 0.47% and 2.9%, and prevalence between 1% and 3%. The risk factors identified were leukemia diagnosis, cranial radiation, thrombocytopenia, coagulopathy, and infection. There was a higher rate of diagnosis with magnetic resonance imaging than with computed tomography scan. Treatment was inconsistent, and patients with cancer were less likely to receive antithrombotic treatment when compared with patients without cancer. The highest mortality was among hemorrhagic stroke. Recurrence rate was 5% to 19%.
The risk for stroke is increased in the pediatric cancer population and can lead to devastating results. The available reports include few patients, with heterogeneous cancer diagnoses and outcomes. Large-scale multicenter studies are needed, focusing on early diagnosis, risk factors, and management strategies of stroke in children with underlying cancer.
儿科癌症患者中风的风险增加。然而，对于儿科癌症早期的中风，我们的了解还存在空白。本项目旨在描述儿科癌症患者中风的现有知识。
系统评价。
根据系统评价和荟萃分析报告的首选项目，从 1995 年 1 月 1 日至 2022 年 2 月 1 日，在 PubMed、Cochrane 和 Google Scholar 中进行了文献检索。
共确定了 3499 项研究，其中 8 项符合纳入标准。儿科癌症患者中风的发生率在 0.47%至 2.9%之间，患病率在 1%至 3%之间。确定的风险因素包括白血病诊断、颅部放疗、血小板减少症、凝血功能障碍和感染。磁共振成像的诊断率高于计算机断层扫描。治疗方法不一致，与无癌症患者相比，癌症患者接受抗血栓治疗的可能性较低。出血性中风的死亡率最高。复发率为 5%至 19%。
儿科癌症患者中风的风险增加，可能导致严重后果。现有报告中的患者数量较少，癌症诊断和结果存在异质性。需要开展大规模的多中心研究，重点关注潜在癌症儿童中风的早期诊断、风险因素和管理策略。
