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|Title||Induction mortality, ATRA administration, and resource utilization in a nationally representative cohort of children with acute promyelocytic leukemia in the United States from 1999 to 2009.|
|Publication Type||Journal Article|
|Year of Publication||2014|
|Authors||Fisher BT, Singh S, Huang YS, Li Y, Gregory J, Walker D, Seif AE, Kavcic M, Aplenc R|
|Journal||Pediatr Blood Cancer|
|Date Published||2014 Jan|
|Keywords||Adolescent, Antineoplastic Agents, Child, Child, Preschool, Cohort Studies, Databases, Factual, Female, Health Resources, Humans, Induction Chemotherapy, Leukemia, Promyelocytic, Acute, Male, Tretinoin, Young Adult|
BACKGROUND: Limited data exist on induction mortality of pediatric patients with acute promyelocytic leukemia in the United States, usage of all-trans retinoic acid (ATRA) during acute promyelocytic leukemia induction, and the resources needed to deliver induction therapy.
PROCEDURE: Using the Pediatric Health Information System database we established a retrospective cohort of patients treated for newly diagnosed acute promyelocytic leukemia with ATRA between January 1999 and September 2009 in 32 of 43 PHIS contributing free-standing pediatric hospitals in the United States. Standard statistical methods were used to determine in-hospital induction mortality, ATRA administration, and resource utilization during a 60-day observation period.
RESULTS: A total of 163 children were identified who met eligibility criteria for cohort inclusion; 52% were female and 76% were white with an average age of 12.7 years. A total of 12 patients (7.4%) died, with 7 (58.3%) dying within the first 7 days of first admission. The mean time to first ATRA exposure increased with decreasing age (P = 0.0016). Resource utilization for management of retinoic acid syndrome was higher than anticipated based on prior studies and differed significantly from patients with non-M3 acute myeloid leukemia.
CONCLUSIONS: The induction mortality for pediatric acute promyelocytic leukemia remains substantial with wide variation in ATRA administration and high rates of resource utilization.
|Alternate Journal||Pediatr Blood Cancer|
|PubMed Central ID||PMC3927454|
|Grant List||P30 CA016520 / CA / NCI NIH HHS / United States |
R01 CA133881 / CA / NCI NIH HHS / United States
R01CA165277 / CA / NCI NIH HHS / United States