{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T08:20:56Z","timestamp":1765354856513,"version":"3.41.2"},"reference-count":20,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,3,2]],"date-time":"2022-03-02T00:00:00Z","timestamp":1646179200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>To assess feasibility and safety of outpatient administration of ifosfamide and etoposide (IE) for pediatric Ewing sarcoma (EWS) patients in a resource\u2010limited setting amid the COVID\u201019 pandemic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>Retrospective study of patients with EWS who received outpatient IE from January 2020 until January 2021 at our institution. Ifosfamide 1800\u00a0mg\/m<jats:sup>2<\/jats:sup> was given for 5\u00a0days with MESNA (2\u2010mercaptoethane sulfonate sodium) infusion and additional boluses before and after 9\u00a0hours of hydration. Patients &gt;10\u00a0years of age with the ability to drink orally at home, no pre\u2010existing renal dysfunction or history of hematuria were included. They were monitored for hemorrhagic cystitis with a urine dipstick before, midway, and at end of infusion. A urine analysis was done 24\u00a0hours after the last dose of ifosfamide.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010seven (100%) cycles were given as outpatient during the study period. Thirty\u2010five (74%) cycles were given on time, two (4%) cycles were delayed due to mucositis, two (4%) due to delayed count recovery, and eight (18%) due to unavailability of outpatient appointments. The median interval between these cycles was 15\u00a0days (range 14\u201344\u00a0days). No episode of hemorrhagic cystitis was reported. Urine analysis was not done at 24\u00a0hours for 27 (58%) cycles, so microscopic hematuria may have been missed. This outpatient protocol saved 32% (USD 299) per cycle in cost and 282\u00a0days of hospitalization.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Outpatient administration of IE for pediatric patients with EWS is feasible, safe, and cost\u2010effective during the COVID\u201019 pandemic.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.29595","type":"journal-article","created":{"date-parts":[[2022,3,2]],"date-time":"2022-03-02T12:19:20Z","timestamp":1646223560000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Feasibility and safety of outpatient administration of ifosfamide and etoposide for pediatric patients with Ewing sarcoma in a resource\u2010limited setting amid the COVID\u201019 pandemic"],"prefix":"10.1002","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2130-4428","authenticated-orcid":false,"given":"Saliha","family":"Sarfraz","sequence":"first","affiliation":[{"name":"Department of Paediatric Oncology Shaukat Khanum Memorial Cancer Hospital and Research Centre  Lahore Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haleema","family":"Saeed","sequence":"additional","affiliation":[{"name":"Department of Paediatric Oncology Shaukat Khanum Memorial Cancer Hospital and Research Centre  Lahore Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,3,2]]},"reference":[{"doi-asserted-by":"publisher","key":"e_1_2_10_2_1","DOI":"10.1016\/j.celrep.2020.01.049"},{"doi-asserted-by":"publisher","key":"e_1_2_10_3_1","DOI":"10.1097\/MPH.0000000000001396"},{"doi-asserted-by":"publisher","key":"e_1_2_10_4_1","DOI":"10.1002\/pbc.20958"},{"doi-asserted-by":"publisher","key":"e_1_2_10_5_1","DOI":"10.29271\/jcpsp.2020.04.446"},{"doi-asserted-by":"publisher","key":"e_1_2_10_6_1","DOI":"10.1200\/JCO.2011.41.5703"},{"doi-asserted-by":"publisher","key":"e_1_2_10_7_1","DOI":"10.1002\/pbc.28409"},{"doi-asserted-by":"publisher","key":"e_1_2_10_8_1","DOI":"10.29271\/jcpsp.2021.Supp3.S83"},{"doi-asserted-by":"publisher","key":"e_1_2_10_9_1","DOI":"10.1634\/theoncologist.2020\u20100213"},{"doi-asserted-by":"publisher","key":"e_1_2_10_10_1","DOI":"10.1002\/pbc.22652"},{"doi-asserted-by":"publisher","key":"e_1_2_10_11_1","DOI":"10.7189\/jogh.10.010367"},{"doi-asserted-by":"publisher","key":"e_1_2_10_12_1","DOI":"10.1371\/journal.pone.0257420"},{"doi-asserted-by":"publisher","key":"e_1_2_10_13_1","DOI":"10.1634\/theoncologist.2020\u20100516"},{"doi-asserted-by":"publisher","key":"e_1_2_10_14_1","DOI":"10.1038\/s41571\u2010020\u20100362\u20106"},{"doi-asserted-by":"publisher","key":"e_1_2_10_15_1","DOI":"10.1016\/j.ejca.2020.06.019"},{"doi-asserted-by":"publisher","key":"e_1_2_10_16_1","DOI":"10.1016\/S1470\u20102045(13)70008"},{"doi-asserted-by":"publisher","key":"e_1_2_10_17_1","DOI":"10.1158\/1055\u20109965.EPI\u201015\u20100578"},{"doi-asserted-by":"publisher","key":"e_1_2_10_18_1","DOI":"10.1596\/978-1-4648-0349-9_ch7"},{"doi-asserted-by":"publisher","key":"e_1_2_10_19_1","DOI":"10.1001\/amajethics.2020.147"},{"doi-asserted-by":"publisher","key":"e_1_2_10_20_1","DOI":"10.1080\/08880018.2020.1772912"},{"doi-asserted-by":"publisher","key":"e_1_2_10_21_1","DOI":"10.1200\/JGO.18.002200"}],"container-title":["Pediatric Blood &amp; 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