PMID- 33258395
OWN - NLM
STAT- MEDLINE
DCOM- 20210430
LR  - 20220402
IS  - 1029-2403 (Electronic)
IS  - 1042-8194 (Print)
IS  - 1026-8022 (Linking)
VI  - 62
IP  - 4
DP  - 2021 Apr
TI  - Quantifying the difference in risk of adverse events by induction treatment 
      regimen in pediatric acute lymphoblastic leukemia.
PG  - 899-908
LID - 10.1080/10428194.2020.1852471 [doi]
AB  - 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.
FAU - West, Zachary E
AU  - West ZE
AD  - Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA.
FAU - Castellino, Sharon M
AU  - Castellino SM
AUID- ORCID: 0000-0001-8367-2002
AD  - Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA.
AD  - Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, 
      Atlanta, GA, USA.
FAU - Monroe, Caitlin
AU  - Monroe C
AD  - Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, 
      Atlanta, GA, USA.
FAU - Thomas, Amanda S
AU  - Thomas AS
AD  - Department of Pediatrics, Biostatistics Core, Emory University School of 
      Medicine, Atlanta, GA, USA.
FAU - McCracken, Courtney
AU  - McCracken C
AD  - Department of Pediatrics, Biostatistics Core, Emory University School of 
      Medicine, Atlanta, GA, USA.
FAU - Miller, Tamara P
AU  - Miller TP
AUID- ORCID: 0000-0003-4250-5376
AD  - Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA.
AD  - Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, 
      Atlanta, GA, USA.
LA  - eng
GR  - K07 CA211956/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20201201
PL  - United States
TA  - Leuk Lymphoma
JT  - Leukemia & lymphoma
JID - 9007422
SB  - IM
MH  - Child
MH  - Cohort Studies
MH  - Humans
MH  - Induction Chemotherapy/adverse effects
MH  - *Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy/epidemiology
PMC - PMC8012228
MID - NIHMS1664593
OTO - NOTNLM
OT  - Adverse events
OT  - clinical trials
OT  - induction
OT  - pediatric oncology
OT  - risk
COIS- Declaration of Interest Statement: The authors report no conflicts of interest.
EDAT- 2020/12/02 06:00
MHDA- 2021/05/01 06:00
PMCR- 2022/04/01
CRDT- 2020/12/01 08:36
PHST- 2020/12/02 06:00 [pubmed]
PHST- 2021/05/01 06:00 [medline]
PHST- 2020/12/01 08:36 [entrez]
PHST- 2022/04/01 00:00 [pmc-release]
AID - 10.1080/10428194.2020.1852471 [doi]
PST - ppublish
SO  - Leuk Lymphoma. 2021 Apr;62(4):899-908. doi: 10.1080/10428194.2020.1852471. Epub 
      2020 Dec 1.