Despite increasing data to support pediatric palliative care (PPC)as an integral component of high-quality care for children with lifethreatening conditions and their families, timely integration of PPC is offered inconsistently to children with high-risk cancer. In this review,  we summarize the growing body of literature in support of early integration of PPC for children with high-risk cancer and their families, advocating that PPC principles and resources are imperative to holistic cancer-directed care and rooted in evidence-based medicine.

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