{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T14:00:26Z","timestamp":1779890426177,"version":"3.53.1"},"reference-count":90,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2020,12,7]],"date-time":"2020-12-07T00:00:00Z","timestamp":1607299200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Pain is one of the most common symptoms in children suffering from leukemia, who are often misdiagnosed with other childhood painful diseases such as juvenile idiopathic arthritis. Corticosteroid-induced osteonecrosis (ON) and vincristine-induced peripheral neuropathy (VIPN) are the most common painful manifestations. Additionally, ongoing pain may continue to impact quality of life in survivorship. This narrative review focuses on the pathophysiological mechanisms of pain in childhood leukemia and current available indications for analgesic treatments. Pain management in children is often inadequate because of difficulties in pain assessment, different indications across countries, and the lack of specific pediatric trials. Analgesic drugs are often prescribed off-label to children by extrapolating information from adult guidelines, with possible increased risk of adverse events. Optimal pain management should involve a multidisciplinary team to ensure assessment and interventions tailored to the individual patient.<\/jats:p>","DOI":"10.3390\/cancers12123671","type":"journal-article","created":{"date-parts":[[2020,12,7]],"date-time":"2020-12-07T21:37:42Z","timestamp":1607377062000},"page":"3671","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Pain Management in Childhood Leukemia: Diagnosis and Available Analgesic Treatments"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7184-5519","authenticated-orcid":false,"given":"Flaminia","family":"Coluzzi","sequence":"first","affiliation":[{"name":"Department Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Polo Pontino, 04100 Latina, Italy"},{"name":"Unit Anesthesia, Intensive Care and Pain Medicine, Sant\u2019Andrea University Hospital, 00189 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8380-3607","authenticated-orcid":false,"given":"Monica","family":"Rocco","sequence":"additional","affiliation":[{"name":"Unit Anesthesia, Intensive Care and Pain Medicine, Sant\u2019Andrea University Hospital, 00189 Roma, Italy"},{"name":"Department of Surgical and Medical Science and Translational Medicine, Sapienza University of Rome, 00189 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rula","family":"Green Gladden","sequence":"additional","affiliation":[{"name":"Seattle Children\u2019s Hospital, Seattle, WA 98105, USA"},{"name":"Department of Medicine, University of Washington School of Medicine, Seattle, WA 98195, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Persiani","sequence":"additional","affiliation":[{"name":"Department of Anatomical, Histological, Forensic Medicine and Orthopedic Science, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurel A.","family":"Thur","sequence":"additional","affiliation":[{"name":"Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Milano","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Washington School of Medicine, Seattle, WA 98195, USA"},{"name":"Department of Anatomical, Histological, Forensic Medicine and Orthopedic Science, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,12,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"950","DOI":"10.15585\/mmwr.mm6636a3","article-title":"Rates and Trends of Pediatric Acute Lymphoblastic Leukemia\u2014United States, 2001\u20132014","volume":"66","author":"Siegel","year":"2017","journal-title":"MMWR Morb. 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