219
Views
4
CrossRef citations to date
0
Altmetric
Original Articles

Quantifying the difference in risk of adverse events by induction treatment regimen in pediatric acute lymphoblastic leukemia

, ORCID Icon, , , & ORCID Icon
Pages 899-908 | Received 17 Jul 2020, Accepted 11 Nov 2020, Published online: 01 Dec 2020
 

Abstract

The differences in overall morbidity by induction treatment regimen for pediatric acute lymphoblastic leukemia (ALL) are unknown. We examined a cohort of children with ALL who received induction chemotherapy between January 2010 and May 2018. We evaluated 20 clinically relevant adverse events (AEs) and readmission and ICU admission rates. Outcomes were compared between standard 3- and 4-drug treatment regimens in multivariate analyses using Cox proportional hazard ratios. Among 486 eligible patients, the risks of sepsis (HR = 2.16, 95% CI = 1.11–4.19), hypoxia (HR = 2.08, 95% CI = 1.03–4.18), hyperbilirubinemia (HR = 2.48, 95% CI = 1.07–5.74), hyperglycemia (HR = 2.65, 95% CI = 1.29–5.42), thromboembolic event (HR = 4.50, 95% CI = 1.30–15.6), and hyponatremia (HR = 7.88, 95% CI = 1.26–49.4) were significantly higher during 4-drug induction. Despite no differences in readmission or ICU admission rates, 4-drug induction patients had greater total inpatient days (12 vs. 4 days; p<.0001). In conclusion, pediatric patients receiving 4-drug induction for ALL experience higher morbidity. These results inform care practices and patient guidance during induction therapy.

Author contributions

TPM, SMC: Conceptualization, methodology, resources, writing – original draft, writing – reviewing & editing. ZEW: Methodology, data curation, writing – original draft, writing – reviewing & editing. CMo: data curation and validation. CMc, AST: formal analysis.

Disclosure statement

The authors report no conflicts of interest.

Data availability statement

Data are available by request from the authors.

Additional information

Funding

This research was funded by National Institutes of Health/National Cancer Institute under Grant Number K07CA211956 (TPM) and the Aflac Cancer and Blood Disorders Center (SMC).

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.