Renewed Hope for the Future: Menin Inhibitors for Relapsed/Refractory Leukemia (233)

Prognosis for pediatric patients and adolescents with multiple relapsed/refractory leukemia remains grim. Many have received relapsed protocols, CAR-T therapies, stem cell transplants and yet, the disease returns. In the past, the next discussion in this patient population would lead towards palliation and quality of life, with little hope for cure. Recent advancement in therapy for children with refractory leukemia has introduced the use of menin inhibitor in patients with KMT2A/MLL and NPM1 mutations, providing a number of young patients with another chance of remission and a chance at a cure. Read more...

Pediatric Anticoagulation: Who, What, When, Where, and Why (and a little How) (225) 

Pediatric anticoagulation can present challenges to the advanced practice nurse (as well as the ambulatory or bedside nurse) with limited experience in the broad scope of clinical scenarios where either prophylactic or treatment anticoagulation is recommended (it's not just clots). Traditionally, the only pharmacologic options utilized in children have been limited to heparin (including low molecular weight heparin) and warfarin. However, direct oral anticoagulants (DOACs) are now being incorporated in a limited fashion, dependent on both age of the child and clinical application. Read more...

Nutritional Support: Best Practices for Pediatric Blood and Marrow Transplant Patients (226)

Nutrition is vital for children to grow and thrive. This is especially important in children with conditions requiring blood and marrow transplantation (BMT) who receive prolonged, intensive therapy requiring optimal overall health and nutritional status (Baumgartner, 2017). Chemotherapy is associated with nausea, vomiting, diarrhea, poor appetite, taste changes, mucositis, and increased catabolic demands (McMillen et al., 2020). Malnutrition rates in the pediatric oncology/BMT population range from 6 to 50% (McMillen et al, 2020), and this can have significant consequences. Read more...

You Deserve to Preserve: A Proposal to Offer Fertility Preservation to All Eligible Pediatric Oncology Patients (221)

Fertility preservation, the opportunity to preserve one’s ability to have genetically-related children prior to damaging or destroying the reproductive system, is a young but rapidly expanding field. Historically, fertility preservation has only been available to postpubertal male and female cancer patients via oocyte, embryo, and sperm cryopreservation. Read more...

Sickle Cell Disease and Increased Hemolysis. When to Consider Evaluating for A Concurrent Hereditary Hemolytic Condition (213-2)

Sickle Cell Disease is an inherited red blood cell disorder that can lead to increased hemolysis which can result in significant anemia. When a child with sickle cell disease does not respond to therapies or interventions designed to decrease hemolysis, then a provider may want to consider the presence of a concurrent inherited hemolytic process such as G6PD, Hereditary Elliptocytosis or Gluthathione reductase deficiency. Read more...

Photobiomodulation for Prevention and Treatment of Oral Mucositis: Part II (214)

Oral mucositis is a significant and common toxicity experienced by patients who receive high-dose chemotherapy as a preparatory regimen for a hematopoietic cell transplant (HCT). Photobiomodulation has been found to be feasible with significant efficacy in preventing the progression of oral mucositis in patients undergoing HCT. Read more...

Neurofibromatosis Therapeutics Program: Program Development, Tumor Treatment, and Side Effect Management (215)

The advanced practice provider is instrumental in designing, developing, and growing a program to treat tumors associated with Neurofibromatosis (NF) Type 1 and 2. Both NF1 and NF2 are autosomal dominant genetic disorders associated with the growth of both benign and malignant tumors of the peripheral and central nervous system. In the last two years selumetinib, a MEK inhibitor, gained FDA approval for treatment of plexiform neurofibromas in the children with NF. Read more...

It's All About the Messaging-Pediatric Palliative Care and Communication (218)

Each year, approximately 16,800 children are diagnosed with cancer. With this diagnosis comes both the hope for a cure and the fear of death. Both hope and fear require our attention and understanding. Children diagnosed with cancer need skilled intradisciplinary treatment teams that provide guidance and support in decisions related to therapy modalities aimed at treating the cancer. Aiming for cure is the hope of all children and families facing a cancer diagnosis. Goals of therapy become very important to designing the best treatment for the child.

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