Improving Treatment Outcomes in Pediatric Oncology Patients Admitted to Intensive Care Units: Current Challenges and Future Strategies in Iran

Hesabi, Amir

doi:10.22034/hp.2026.604940.1101

Improving Treatment Outcomes in Pediatric Oncology Patients Admitted to Intensive Care Units: Current Challenges and Future Strategies in Iran

Document Type : Letter to the Editor

Author

Amir Hesabi

Pediatric Hematology and Oncology, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.

10.22034/hp.2026.604940.1101

Abstract

Improvements in survival among children with cancer, together with increasingly complex treatment regimens, hematopoietic stem-cell transplantation, and targeted therapies, have increased the need for admission to pediatric intensive care units (PICUs). In Iran, overall survival among children with cancer has improved in recent years; however, mortality among children with cancer admitted to the PICU remains higher than that reported for the general PICU population. Sepsis, multi-organ dysfunction, central nervous system involvement, and high-risk hematologic malignancies are major contributors to mortality in this population. Delayed recognition of clinical deterioration, drug-resistant infections, late referral, and inequitable access to specialized services remain important challenges in the care of these patients in Iran. Effective strategies include the implementation of pediatric early warning systems, antimicrobial stewardship programs, strengthened collaboration between oncology and PICU teams, optimization of nutritional support, early integration of palliative care, and family-centered care. Developing local clinical guidelines, training healthcare personnel, and establishing multicenter databases may help reduce preventable mortality and improve the quality of care.

Keywords

Iranian health system

Multi-organ dysfunction

Pediatric intensive care

Pediatric oncology

Sepsis