Abstract
Survival for pediatric patients diagnosed with cancer has improved significantly. This achievement has been made possible due to new treatment modalities and the incorporation of a systematic multidisciplinary approach for supportive care. Understanding the distinctive cardiovascular characteristics of children undergoing cancer therapies has set the underpinnings to provide comprehensive care before, during, and after the management of cancer. Nonetheless, we acknowledge the challenge to understand the rapid expansion of oncology disciplines. The limited guidelines in pediatric cardio-oncology have motivated us to develop risk-stratification systems to institute surveillance and therapeutic support for this patient population. Here, we describe a collaborative approach to provide wide-ranging cardiovascular care to children and young adults with oncology diseases. Promoting collaboration in pediatric cardio-oncology medicine will ultimately provide excellent quality of care for future generations of patients.
Highlights
There has been a significant improvement in the care and survival of pediatric patients diagnosed with cancer [1]
Medical therapy for compensated systolic heart failure with ACEi and angiotensin receptor blockers (ARBs) is recommended to initiated at a low dose and uptitrated to the recommended target dosage based on tolerance [53,54]
With the rapid development of anti-cancer modalities, early CV adversities, and long-term sequelae from some therapies, there has been a demand to propel the evolution of pediatric cardio-oncology (PedCO)
Summary
There has been a significant improvement in the care and survival of pediatric patients diagnosed with cancer (e.g., leukemia/lymphoma and solid tumor) [1]. In 2016, the Heart Institute at Le Bonheur Children’s Hospital (LBCH) began to expand relationships with clinical specialties at St. Jude Children’s Research Hospital (SJCRH) to deliver comprehensive CV healthcare, institute academic pathways, and advance research collaboration to improve outcomes in children and young adults undergoing cancer and hematology treatments. The pediatric cardio-oncology (PedCO) team comprises a set of consulting cardiologists with expertise in myocardial disease. The “front-line” team is present during daily medical rounds, identifying, evaluating, and optimizing therapy for patients with clinical and subclinical CTRCD. An in-house PedCO team allows for shifting the paradigm from managing manifested cardiovascular illness to preventing and identifying subclinical disease. The purpose of this review is to outline the multidisciplinary collaboration between the cardiovascular services from LBCH and the oncology/hematology providers at SJCRH to achieve an exceptional clinical and academic practice for children with co-existing cardiovascular and oncology disease
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