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Accepted (AM)Open Access (License Unspecified), Open
Journal article
Presentation acuity, induction mortality, and resource utilization in infants with acute leukemia
PEDIATRIC BLOOD & CANCER, v 68(7), e28940
Jul 2021
PMID: 33704911
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background Treatment of infants with acute leukemia remains challenging, especially for acute lymphocytic leukemia (ALL). Infants have shown markedly higher rates of induction mortality compared with noninfants. There are limited data on presentation acuity and supportive care utilization in this age group. Methods In retrospective analyses of patients treated for new onset ALL or acute myeloid leukemia (AML) at pediatric hospitals contributing to the Pediatric Health Information System, we compared presentation acuity, induction mortality, and resource utilization in infants relative to noninfants less than 10 years at diagnosis. Results Analyses included 10 359 children with ALL (405 infants, 9954 noninfants) and 871 AML (189 infants, 682 noninfants). Infants were more likely to present with multisystem organ failure compared to noninfants for both ALL (12% and 1%, PR = 10.8, 95% CI: 7.4, 15.7) and AML (6% vs. 3%; PR = 2.0, 95% CI: 1.0, 3.7). Infants with ALL had higher induction mortality compared to noninfants, even after accounting for differences in anthracycline exposure and presentation acuity (2.7% vs. 0.5%, HR = 2.1, 95% CI: 1.0, 4.8). Conversely, infants and noninfants with AML had similar rates of induction mortality (3.2% vs. 2.1%, HR = 1.2, 95% CI: 0.3, 3.9), which were comparable to rates among infants with ALL. Infants with ALL and AML had greater requirements for blood products, diuretics, supplemental oxygen, and ventilation during induction relative to noninfants. Conclusions Infants with leukemia present with higher acuity compared with noninfants. Induction mortality and supportive care requirements for infants with ALL were similar to all children with AML, and significantly higher than those for noninfants with ALL.
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Details
- Title
- Presentation acuity, induction mortality, and resource utilization in infants with acute leukemia
- Publication Details
- PEDIATRIC BLOOD & CANCER, v 68(7), e28940
- Publisher
- WILEY; HOBOKEN
- Grant note
- National Heart, Lung, and Blood Institute, Grant/Award Number: 5K01HL143153; Alex's Lemonade Stand Foundation for Childhood Cancer; National Cancer Institute, Grant/Award Number: 5K07CA211956
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Drexel University
- Web of Science ID
- WOS:000627498100001
- Scopus ID
- 2-s2.0-85102612103
- Other Identifier
- 991021860654604721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Hematology
- Oncology
- Pediatrics