{"id":156,"date":"2020-12-14T13:38:00","date_gmt":"2020-12-14T12:38:00","guid":{"rendered":"https:\/\/onetech.dev\/covid\/?page_id=156"},"modified":"2026-04-22T15:35:08","modified_gmt":"2026-04-22T14:35:08","slug":"pediatrique","status":"publish","type":"page","link":"https:\/\/onetech.dev\/covid\/pediatrique","title":{"rendered":"P\u00e9diatrique"},"content":{"rendered":"<section class=\"l-section wpb_row height_small\"><div class=\"l-section-h i-cf\"><div class=\"g-cols vc_row via_grid cols_1 laptops-cols_inherit tablets-cols_inherit mobiles-cols_1 valign_top type_default stacking_default\"><div class=\"wpb_column vc_column_container type_sticky\"><div class=\"vc_column-inner\" style=\"top:180px\"><div class=\"w-image us_custom_fb33871a us_animate_this has_height align_center\"><div class=\"w-image-h\"><img decoding=\"async\" width=\"900\" height=\"127\" src=\"https:\/\/onetech.dev\/covid\/data\/irc_logo.png\" class=\"attachment-full size-full\" alt=\"\" loading=\"lazy\" srcset=\"https:\/\/onetech.dev\/covid\/data\/irc_logo.png 900w, https:\/\/onetech.dev\/covid\/data\/irc_logo-300x42.png 300w, https:\/\/onetech.dev\/covid\/data\/irc_logo-150x21.png 150w\" sizes=\"auto, (max-width: 900px) 100vw, 900px\" \/><\/div><\/div><div class=\"ult-spacer spacer-69f4102dd8956\" data-id=\"69f4102dd8956\" data-height=\"35\" data-height-mobile=\"35\" data-height-tab=\"35\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div><h3 class=\"w-text us_custom_7ccf62ca has_text_color\"><span class=\"w-text-h\"><span class=\"w-text-value\">RECOMMANDATIONS G\u00c9N\u00c9RALES<\/span><\/span><\/h3><\/div><\/div><\/div><\/div><\/section><section class=\"l-section wpb_row height_small\"><div class=\"l-section-h i-cf\"><div class=\"g-cols vc_row via_grid cols_1 laptops-cols_inherit tablets-cols_inherit mobiles-cols_1 valign_top type_default stacking_default\"><div class=\"wpb_column vc_column_container\"><div class=\"vc_column-inner\"><div class=\"g-cols wpb_row via_grid cols_2-1 laptops-cols_inherit tablets-cols_inherit mobiles-cols_1 valign_top type_default stacking_default\" style=\"--columns-gap:3rem;\"><div class=\"wpb_column vc_column_container\"><div class=\"vc_column-inner\"><div class=\"aio-icon-component    style_2\"><a class=\"aio-icon-box-link\" ><div id=\"Info-box-wrap-2466\" class=\"aio-icon-box left-icon\" style=\"\"  ><div class=\"aio-icon-left\"><div class=\"ult-just-icon-wrapper  \"><div class=\"align-icon\" style=\"text-align:center;\">\n<div class=\"aio-icon-img \" style=\"font-size:50px;background:#03254C;border-style:solid;border-color:#03254C;border-width:1px;padding:20px;border-radius:500px;display:inline-block;\" >\n\t<img decoding=\"async\" class=\"img-icon\" alt=\"null\" src=\"https:\/\/onetech.dev\/covid\/data\/child.png\"\/>\n<\/div><\/div><\/div><\/div><div class=\"aio-ibd-block\"><div class=\"aio-icon-header\" ><h6 class=\"aio-icon-title ult-responsive\"  data-ultimate-target='#Info-box-wrap-2466 .aio-icon-title'  data-responsive-json-new='{\"font-size\":\"\",\"line-height\":\"\"}'  style=\"font-weight:bold;color:#03254C;\">P\u00e9diatrique<\/h6><\/div> <!-- header --><\/div> <!-- aio-ibd-block --><\/div> <!-- aio-icon-box --><\/a><\/div> <!-- aio-icon-component --><\/div><\/div><div class=\"wpb_column vc_column_container\"><div class=\"vc_column-inner\"><div class=\"w-btn-wrapper align_right\"><a class=\"w-btn us-btn-style_1 icon_atleft\" href=\"https:\/\/onetech.dev\/covid\/\"><i class=\"far fa-backward\"><\/i><span class=\"w-btn-label\">Retour<\/span><\/a><\/div><\/div><\/div><\/div><div class=\"ult-spacer spacer-69f4102dd9779\" data-id=\"69f4102dd9779\" data-height=\"25\" data-height-mobile=\"25\" data-height-tab=\"25\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div><div class=\"g-cols wpb_row via_grid cols_1 laptops-cols_inherit tablets-cols_inherit mobiles-cols_1 valign_top type_default stacking_default\" style=\"--columns-gap:3rem;\"><div class=\"wpb_column vc_column_container us_custom_7e20fa79 us_animate_this\"><div class=\"vc_column-inner\"><div class=\"w-tabs us_custom_064d3121 style_default switch_click accordion has_scrolling\" style=\"--sections-title-size:18px\"><div class=\"w-tabs-sections titles-align_none icon_chevron cpos_right\"><div class=\"w-tabs-section active\" id=\"d0ee\"><button class=\"w-tabs-section-header active\" aria-controls=\"content-d0ee\" aria-expanded=\"true\"><div class=\"w-tabs-section-title\">1) Leuc\u00e9mie aigue lymphoblastique (LAL)<\/div><div class=\"w-tabs-section-control\"><\/div><\/button><div  class=\"w-tabs-section-content us_custom_ea76afbe\" id=\"content-d0ee\"><div class=\"w-tabs-section-content-h i-cf\"><div class=\"wpb_text_column\"><div class=\"wpb_wrapper\"><p style=\"text-align: justify;\">La LAL est le cancer le plus fr\u00e9quent chez l\u2019enfant avec la dur\u00e9e la plus longue de traitement. Si les investigations ( cytom\u00e9trie en flux et \/ ou biologie mol\u00e9culaire) ne sont pas disponibles temporairement, il est recommand\u00e9 de stratifier les enfants selon les crit\u00e8res classiques et les traiter par le traitement standard.\u00a0 Les phases d\u2019induction et de consolidation doivent absolument \u00eatre maintenues. En cas d\u2019impossibilit\u00e9 d\u2019acc\u00e8s aux structures de soins, discuter le maintien du patient sous purinethol et m\u00e9thotrexate faible dose et diff\u00e9rer si besoin les cures de M\u00e9thotrexate \u00e0 Haute dose. Utiliser les facteurs de croissance en cas de neutrop\u00e9nie. \u00a0 Aucune modification du traitement d\u2019entretien n\u2019est recommand\u00e9e<\/p>\n<\/div><\/div><\/div><\/div><\/div><div class=\"w-tabs-section\" id=\"k22e\"><button class=\"w-tabs-section-header\" aria-controls=\"content-k22e\" aria-expanded=\"false\"><div class=\"w-tabs-section-title\">2) Lymphome de Burkitt<\/div><div class=\"w-tabs-section-control\"><\/div><\/button><div  class=\"w-tabs-section-content us_custom_71d3e3d1\" id=\"content-k22e\"><div class=\"w-tabs-section-content-h i-cf\"><div class=\"wpb_text_column\"><div class=\"wpb_wrapper\"><p style=\"text-align: justify;\">C\u2019est la\u00a0Pathologie maligne la plus agressive chez l\u2019enfant. Il faut \u00eatre plus vigilant et rigoureux dans la gestion des soins de support durant la pr\u00e9phase et maintenir si possible les patients en hospitalisation pour \u00e9viter les risques d\u2019arr\u00eat de traitement ou de retard entre les cures<\/p>\n<\/div><\/div><\/div><\/div><\/div><div class=\"w-tabs-section\" id=\"b340\"><button class=\"w-tabs-section-header\" aria-controls=\"content-b340\" aria-expanded=\"false\"><div class=\"w-tabs-section-title\">3) Lymphome Hodgkinien<\/div><div class=\"w-tabs-section-control\"><\/div><\/button><div  class=\"w-tabs-section-content us_custom_71d3e3d1\" id=\"content-b340\"><div class=\"w-tabs-section-content-h i-cf\"><div class=\"wpb_text_column\"><div class=\"wpb_wrapper\"><p style=\"text-align: justify;\">Il est possible que les investigations soient inaccessibles\u00a0 ce qui compromet le staging et l\u2019\u00e9valuation th\u00e9rapeutique. Les adaptations de traitement se feront au cas par cas en privil\u00e9giant les cures pouvant \u00eatre administr\u00e9es en h\u00f4pital de jour et en un seul jour.<\/p>\n<\/div><\/div><\/div><\/div><\/div><div class=\"w-tabs-section\" id=\"g5ab\"><button class=\"w-tabs-section-header\" aria-controls=\"content-g5ab\" aria-expanded=\"false\"><div class=\"w-tabs-section-title\">4) Les tumeurs solides<\/div><div class=\"w-tabs-section-control\"><\/div><\/button><div  class=\"w-tabs-section-content us_custom_71d3e3d1\" id=\"content-g5ab\"><div class=\"w-tabs-section-content-h i-cf\"><div class=\"wpb_text_column\"><div class=\"wpb_wrapper\"><p style=\"text-align: justify;\"><strong>a) La chimioth\u00e9rapie\u00a0<\/strong><\/p>\n<p style=\"text-align: justify;\">Des adaptations de traitement sont \u00e0 discuter au cas par cas en privil\u00e9giant les cures administrables tous les 21 \u00e0 28 jours et en utilisant les drogues ne n\u00e9cessitant pas une hospitalisation longue ou une hydratation importante (exp Cyclophosphamide au lieu de l\u2019ifosfamide)<\/p>\n<p style=\"text-align: justify;\"><strong>b)\u00a0 Radioth\u00e9rapie \u00a0<\/strong><\/p>\n<p style=\"text-align: justify;\">La coordination entre radioth\u00e9rapeute et oncologue p\u00e9diatre est essentielle afin d\u2019hi\u00e9rarchiser\u00a0 les cas en fonction de l\u2019urgence et de la curabilit\u00e9 du cancer.<\/p>\n<p style=\"text-align: justify;\"><strong>c) Chirurgie :\u00a0<\/strong><\/p>\n<p style=\"text-align: justify;\">\u00a0Les recommandations pour la chirurgie du cancer p\u00e9diatrique doivent \u00eatre adapt\u00e9es en fonction de la\u00a0 pr\u00e9valence du COVID-19et la capacit\u00e9 du syst\u00e8me de sant\u00e9. La planification des interventions chirurgicales est une d\u00e9cision partag\u00e9e impliquant l&rsquo;\u00e9quipe de soins contre le cancer et la direction de l&rsquo;h\u00f4pital. Un retard peut \u00eatre envisag\u00e9 si l\u2019acc\u00e8s aux soins intensifs post op\u00e9ratoire est limit\u00e9 ou la tumeur est de bas grade ou faible risque m\u00e9tastatique.<\/p>\n<p style=\"text-align: justify;\"><strong>d) Transfusion :\u00a0<\/strong><\/p>\n<p style=\"text-align: justify;\">Les centres sont invit\u00e9s \u00e0 revoir leur utilisation des produits sanguins et les seuils transfusionnels. Il est recommand\u00e9 de maintenir un seuil d\u2019h\u00e9moglobine &gt; 7 g\/dl si l\u2019enfant est asymptomatique et un seuil de plaquettes \u00e0 10 000\/mm3 en l\u2019absence de facteurs de risque de saignement en dehors des proc\u00e9dures ( PL, biopsie, chirurgie \u2026).<\/p>\n<p style=\"text-align: justify;\">Ces adaptations doivent \u00eatre de courte dur\u00e9e avec un retour aux proc\u00e9dures et protocoles standards le plus t\u00f4t possible.<\/p>\n<p style=\"text-align: justify;\"><u>R\u00e9f\u00e9rences\u00a0:<\/u><\/p>\n<ul>\n<li style=\"text-align: justify;\">Ruggiero A, Romano A, Attin\u00e0 G. Covid 19 and children with cancer : are they at increased risk of infection<br \/>\nPediatr Res. 2020 Apr 23. doi: 10.1038\/s41390-020-0919-1.<\/li>\n<li style=\"text-align: justify;\">Janssens GO, Mandeville HC, Timmermann B, Maduro JH, Alapetite C, Padovani L, Horan G, Lassen-Ramshad Y, Dieckmann K, Ruebe C, Thorp N, Gandola L, Ajithkumar T, Boterberg T. A rapid review of evidence and recommendations from the SIOPE Radiation oncology group to help mitigate for reduced paediatic radiotherapy capacity during COVID 19 pandemic. Radiother Oncol. 2020 Apr 26. pii: S0167-8140(20)30216-4. doi: 10.1016\/j.radonc.2020.04.035<\/li>\n<\/ul>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"ult-spacer spacer-69f4102ddabc3\" data-id=\"69f4102ddabc3\" data-height=\"35\" data-height-mobile=\"35\" data-height-tab=\"35\" data-height-tab-portrait=\"\" data-height-mobile-landscape=\"\" style=\"clear:both;display:block;\"><\/div><div class=\"g-cols wpb_row us_custom_60e9caca us_animate_this via_grid cols_1 laptops-cols_inherit tablets-cols_inherit mobiles-cols_1 valign_top type_default stacking_default\" style=\"--columns-gap:3rem;\"><div class=\"wpb_column vc_column_container\"><div class=\"vc_column-inner\"><div class=\"w-text us_custom_7ccf62ca has_text_color\"><span class=\"w-text-h\"><span class=\"w-text-value\">PARTENAIRES<\/span><\/span><\/div><\/div><\/div><\/div><div class=\"w-image align_center\"><div class=\"w-image-h\"><img decoding=\"async\" width=\"1300\" height=\"231\" src=\"https:\/\/onetech.dev\/covid\/data\/partenaire.png\" class=\"attachment-full size-full\" alt=\"\" loading=\"lazy\" srcset=\"https:\/\/onetech.dev\/covid\/data\/partenaire.png 1300w, https:\/\/onetech.dev\/covid\/data\/partenaire-300x53.png 300w, https:\/\/onetech.dev\/covid\/data\/partenaire-1024x182.png 1024w, https:\/\/onetech.dev\/covid\/data\/partenaire-150x27.png 150w\" sizes=\"auto, (max-width: 1300px) 100vw, 1300px\" \/><\/div><\/div><\/div><\/div><\/div><\/div><\/section>\n","protected":false},"excerpt":{"rendered":"RECOMMANDATIONS G\u00c9N\u00c9RALES P\u00e9diatrique Retour1) Leuc\u00e9mie aigue lymphoblastique (LAL) La LAL est le cancer le plus fr\u00e9quent chez l\u2019enfant avec la dur\u00e9e la plus longue de traitement. Si les investigations ( cytom\u00e9trie en flux et \/ ou biologie mol\u00e9culaire) ne sont pas disponibles temporairement, il est recommand\u00e9 de stratifier les enfants selon les crit\u00e8res classiques et...","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-156","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/onetech.dev\/covid\/wp-json\/wp\/v2\/pages\/156","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/onetech.dev\/covid\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/onetech.dev\/covid\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/onetech.dev\/covid\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/onetech.dev\/covid\/wp-json\/wp\/v2\/comments?post=156"}],"version-history":[{"count":1,"href":"https:\/\/onetech.dev\/covid\/wp-json\/wp\/v2\/pages\/156\/revisions"}],"predecessor-version":[{"id":157,"href":"https:\/\/onetech.dev\/covid\/wp-json\/wp\/v2\/pages\/156\/revisions\/157"}],"wp:attachment":[{"href":"https:\/\/onetech.dev\/covid\/wp-json\/wp\/v2\/media?parent=156"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}