Identifying relapses and stem cell transplants in pediatric acute lymphoblastic leukemia using administrative data: Capturing national outcomes irrespective of trial enrollment.

Autor: Cahen VC; Center for Childhood Cancer Research, Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania., Li Y; Center for Childhood Cancer Research, Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.; Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania.; Department of Pediatrics, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania., Getz KD; Center for Childhood Cancer Research, Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.; Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania.; Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania., Elgarten CW; Center for Childhood Cancer Research, Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania., DiNofia AM; Center for Childhood Cancer Research, Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.; Department of Pediatrics, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania., Wilkes JJ; Division of Hematology/Oncology, Seattle Children's Hospital and the Department of Pediatrics, University of Washington, Seattle, Washington., Winestone LE; Division of Blood and Marrow Transplantation, UCSF Benioff Children's Hospital, University of California - San Francisco, San Francisco, California., Huang YV; Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania., Miller TP; Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia.; Department of Pediatrics, Emory University, Atlanta, Georgia., Gramatges MM; Division of Hematology-Oncology, Department of Pediatrics, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas., Rabin KR; Division of Hematology-Oncology, Department of Pediatrics, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas., Fisher BT; Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania.; Department of Pediatrics, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania.; Division of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania., Aplenc R; Center for Childhood Cancer Research, Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.; Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania.; Department of Pediatrics, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania., Seif AE; Center for Childhood Cancer Research, Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.; Department of Pediatrics, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania.; Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Jazyk: angličtina
Zdroj: Pediatric blood & cancer [Pediatr Blood Cancer] 2021 Sep; Vol. 68 (9), pp. e28315. Date of Electronic Publication: 2020 May 11.
DOI: 10.1002/pbc.28315
Abstrakt: Introduction: Our objectives were to design and validate methods to identify relapse and hematopoietic stem cell transplantation (HSCT) in children with acute lymphoblastic leukemia (ALL) using administrative data representing hospitalizations at US pediatric institutions.
Methods: We developed daily billing and ICD-9 code definitions to identify relapses and HSCTs within a cohort of children with newly diagnosed ALL between January 1, 2004, and December 31, 2013, previously assembled from the Pediatric Health Information System (PHIS) database. Chart review for children with ALL at the Children's Hospital of Philadelphia (CHOP) and Texas Children's Hospital (TCH) was performed to establish relapse and HSCT gold standards for sensitivity and positive predictive value (PPV) calculations. We estimated incidences of relapse and HSCT in the PHIS ALL cohort.
Results: We identified 362 CHOP and 314 TCH ALL patients in PHIS and established true positives by chart review. Sensitivity and PPV for identifying both relapse and HSCT in PHIS were > 90% at both hospitals. Five-year relapse incidence in the 10 150-patient PHIS cohort was 10.3% (95% CI 9.8%-10.9%) with 7.1% (6.6%-7.6%) of children underwent HSCTs. Patients in higher-risk demographic groups had higher relapse and HSCT rates. Our analysis also identified differences in incidences of relapse and HSCT by race, ethnicity, and insurance status.
Conclusions: Administrative data can be used to identify relapse and HSCT accurately in children with ALL whether they occur on- or off-therapy, in contrast with published approaches. This method has wide potential applicability for estimating these incidences in pediatric ALL, including patients not enrolled on clinical trials.
(© 2020 Wiley Periodicals LLC.)
Databáze: MEDLINE
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