PMID- 31502412
OWN - NLM
STAT- MEDLINE
DCOM- 20200316
LR  - 20201201
IS  - 1545-5017 (Electronic)
IS  - 1545-5009 (Print)
IS  - 1545-5009 (Linking)
VI  - 66
IP  - 12
DP  - 2019 Dec
TI  - Impact of fluid overload and infection on respiratory adverse event development 
      during induction therapy for childhood acute myeloid leukemia.
PG  - e27975
LID - 10.1002/pbc.27975 [doi]
AB  - BACKGROUND: Treatment-related morbidity and mortality occur frequently in 
      childhood acute myeloid leukemia (AML) induction. Yet the contributions of 
      respiratory adverse events (AEs) within this population are poorly understood. 
      Furthermore, the roles of fluid overload (FO) and infection in AML pulmonary 
      complications have been inadequately examined. OBJECTIVES: To describe the 
      incidence, categories, and grades of respiratory AEs and to assess the 
      associations of FO and infection on respiratory AE development in childhood AML 
      induction. METHODS: We retrospectively examined the induction courses of a cohort 
      of de novo pediatric AML patients for any NCI CTCAE grade 2 to 5 respiratory AE, 
      FO, and systemic/pulmonary infection occurrence. Demographic, disease, and 
      treatment-related data were abstracted. Descriptive, univariate, survival, and 
      multivariable analyses were conducted. RESULTS: Among 105 eligible subjects from 
      2009 to 2016, 49.5% (n = 52) experienced 63 discrete respiratory AEs. FO occurred 
      in 28.6% of subjects (n = 30), with half occurring within 24 hours of 
      hospitalization. Positive FO status < 10 days (aHR 5.5, 95% CI 2.3-12.8), >/= 10 
      days (aHR 13, 95% CI 4.1-41.8), and positive infection status >/= 10 days into 
      treatment (aHR 14.9, 5.4-41.6) were each independently associated with AE 
      development. CONCLUSIONS: We describe a higher incidence of respiratory AEs 
      during childhood AML induction than previously illustrated. FO occurs frequently 
      and early in this course. Late infections and FO at any time frame were strongly 
      associated with AE development. Interventions focused on the prevention and 
      management of FO and infectious respiratory complications could be instrumental 
      in reducing preventable treatment-related morbidity and mortality.
CI  - (c) 2019 Wiley Periodicals, Inc.
FAU - Miller, Lane H
AU  - Miller LH
AUID- ORCID: 0000-0003-1995-9492
AD  - Department of Pediatrics, Emory University, Aflac Cancer and Blood Disorders 
      Center, Children's Healthcare of Atlanta, Atlanta, Georgia.
FAU - Keller, Frank
AU  - Keller F
AD  - Department of Pediatrics, Emory University, Aflac Cancer and Blood Disorders 
      Center, Children's Healthcare of Atlanta, Atlanta, Georgia.
FAU - Mertens, Ann
AU  - Mertens A
AD  - Department of Pediatrics, Emory University, Aflac Cancer and Blood Disorders 
      Center, Children's Healthcare of Atlanta, Atlanta, Georgia.
FAU - Klein, Mitchel
AU  - Klein M
AD  - Department of Epidemiology, Rollins School of Public Health, Emory University, 
      Atlanta, Georgia.
FAU - Allen, Kristen
AU  - Allen K
AD  - Department of Pediatrics, Emory University, Aflac Cancer and Blood Disorders 
      Center, Children's Healthcare of Atlanta, Atlanta, Georgia.
FAU - Castellino, Sharon
AU  - Castellino S
AD  - Department of Pediatrics, Emory University, Aflac Cancer and Blood Disorders 
      Center, Children's Healthcare of Atlanta, Atlanta, Georgia.
FAU - Woods, William G
AU  - Woods WG
AD  - Department of Pediatrics, Emory University, Aflac Cancer and Blood Disorders 
      Center, Children's Healthcare of Atlanta, Atlanta, Georgia.
LA  - eng
GR  - UL1 TR002378/TR/NCATS NIH HHS/United States
GR  - UL1TR002378/TR/NCATS NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20190910
PL  - United States
TA  - Pediatr Blood Cancer
JT  - Pediatric blood & cancer
JID - 101186624
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Antineoplastic Combined Chemotherapy Protocols/*adverse effects
MH  - Child
MH  - Child, Preschool
MH  - Edema/*complications
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Induction Chemotherapy/*adverse effects
MH  - Infant
MH  - Infant, Newborn
MH  - Infections/*complications
MH  - Leukemia, Myeloid, Acute/*drug therapy/pathology
MH  - Male
MH  - Prognosis
MH  - Respiratory Tract Diseases/etiology/*pathology
MH  - Retrospective Studies
MH  - Survival Rate
MH  - Water-Electrolyte Imbalance/*complications
MH  - Young Adult
PMC - PMC6803045
MID - NIHMS1049645
OTO - NOTNLM
OT  - AML
OT  - adverse
OT  - fluid
OT  - induction
OT  - infection
OT  - respiratory
COIS- DISCLOSURE OF CONCLICTS OF INTEREST The authors declare no conflicts of interest.
EDAT- 2019/09/11 06:00
MHDA- 2020/03/17 06:00
PMCR- 2020/12/01
CRDT- 2019/09/11 06:00
PHST- 2019/03/01 00:00 [received]
PHST- 2019/07/03 00:00 [revised]
PHST- 2019/07/26 00:00 [accepted]
PHST- 2019/09/11 06:00 [pubmed]
PHST- 2020/03/17 06:00 [medline]
PHST- 2019/09/11 06:00 [entrez]
PHST- 2020/12/01 00:00 [pmc-release]
AID - 10.1002/pbc.27975 [doi]
PST - ppublish
SO  - Pediatr Blood Cancer. 2019 Dec;66(12):e27975. doi: 10.1002/pbc.27975. Epub 2019 
      Sep 10.