Pediatric Hematology and Oncology

Pediatric Hematology and Oncology Outcomes

2022

Diagnosis to First Treatment

2018 - 2022

After infancy, cancer is the leading cause of death by disease among US children. The Cleveland Clinic Children's hematology and oncology program works to reduce the time to treatment: the time period between cancer diagnosis and the initiation of treatment.

Sample Sizes20182019202020212022
ALL (all patients with pediatric cancer)N=58N=49N=61N=46N = 41
Excluding Patients with TTT (Time to Treat) < 0 (see below)N=26N=24N=28N=24N = 14

ALL: All pediatric cancer patients

TTT (Time to Treat) >0: Removed patients who were diagnosed and began treatment on the same day (e.g. biopsy and surgery on same day)

Pediatric Cancer Survival Rates by Type

2007 - 2022

According to the latest US News and World Report scorecard, Cleveland Clinic Children's five-year cancer survival rates are above average nationally.

NEW= New pediatric cancer patients (All diagnoses)

ALL = acute lymphocytic leukemia

AML = acute myeloid leukemia

CNS = central nervous system

Fever & Presumed Neutropenia Antibiotic Administration within 60 Minutes

2019 - 2022

Fever and neutropenia are expected complications in children receiving chemotherapy for cancer. Management guidelines have been developed specifically for this pediatric population. Outcomes are dependent on timely intervention, especially time to antibiotic (ATB) delivery. A recent study of the pediatric hematology and oncology population at a large university practice during a 15-month period found that antibiotics were delivered within 59 minutes of outpatient check-in to all patients with cancer presenting with fever and neutropenia; the reported median time to ATB delivery was 43 minutes.¹ By adopting national guidelines for patients with fever and neutropenia, Cleveland Clinic Children’s aims to improve outcomes by administering ATBs within 60 minutes of a patient’s arrival on the hospital floor or in an outpatient clinic.

In 2022, a total of 100% of inpatients with fever and presumed neutropenia received antibiotics within 60 minutes of arriving.

¹Salstrom JL, Coughlin RL, Pool K, Bojan M, Mediavilla C, Schwent W, Rannie M, Law D, Finnerty M, Hilden J. Pediatric patients who receive antibiotics for fever and neutropenia in less than 60 minutes have decreased intensive care needs. Pediatr Blood Cancer. 2015 May;62(5):807-815.

Non-Mucosal Barrier Central Line-Associated Bloodstream Infections

2017 - 2022

CL = central line, NHSN = National Healthcare Safety Network

ᵃNational Healthcare Safety Network 2016–2017 benchmark for central line-associated bloodstream infections (CLABSI) is 2.4/1000 central line days for pediatric hematopoietic stem cell transplant ward. NHSN no longer uses benchmarks for CLABSI rate.

Non-MBI CLABSI refers to a CLABSI that is not due to a mucosal barrier injury. This distinction is important in blood and marrow transplants where many of the patients are at risk for mucosal breakdown.