Abdominal Complications During Treatment for Pediatric Acute Myeloid Leukemia.

Autor:	Borgstedt-Bendixen SE; Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark., Abrahamsson J; Department of Pediatrics, Institution for Clinical Sciences, Queen Silvia Children's Hospital, Gothenburg., Ha SY; Department of Pediatrics, Queen Mary Hospital and Hong Kong Pediatric Hematology and Oncology Study Group (HKPHOSG), Hong Kong, China., Koskenvuo M; Division of Hematology-Oncology and Stem Cell Transplantation, Children's Hospital and Helsinki University Central Hospital, Helsinki, Finland., Lausen B; Department of Pediatrics and Adolescent Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark., Palle J; Department of Woman's and Children's Health, Uppsala University, Uppsala, Sweden., Zeller B; Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway., Hasle H; Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark., Løhmann DJA; Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark.
Jazyk:	angličtina
Zdroj:	Journal of pediatric hematology/oncology [J Pediatr Hematol Oncol] 2022 Jul 01; Vol. 44 (5), pp. 220-229. Date of Electronic Publication: 2021 Aug 16.
DOI:	10.1097/MPH.0000000000002281
Abstrakt:	Acute myeloid leukemia (AML) accounts for 15% to 20% of childhood leukemias. Because of high-intensive therapy, up to 5% of patients suffer from treatment-related mortality (TRM). Abdominal complications are frequent, however, literature on this subject is sparse. We aimed to characterize severe abdominal pain (AP) and hyperbilirubinemia experienced by pediatric AML patients treated according to the Nordic Society of Pediatric Hematology and Oncology (NOPHO)-AML 2004 protocol (n=313). Patients were censored at hematopoietic stem cell transplantation and relapse. Toxicity information was collected prospectively. Additional information was requested retrospectively from the treating centers. Sixteen episodes of hyperbilirubinemia and 107 episodes of AP were reported. The treating centers deemed infection (30%) and typhlitis (18%) as the most frequent causes of AP. Six patients developed appendicitis (2%). Patients experiencing concurrent AP and sepsis had a high risk of TRM (36%, n=4). Eighty percent of episodes with hyperbilirubinemia fulfilled the European Society for Bone and Marrow Transplantation criteria for sinusoidal obstruction syndrome. In conclusion, abdominal complications were frequent with infection considered the predominate cause. Most patients with hyperbilirubinemia fulfilled the criteria for sinusoidal obstruction syndrome. AML treatment might be associated with appendicitis. Patients suffering from concurrent AP and sepsis had a high risk of TRM indicating that high awareness of abdominal complications is essential to reduce mortality, especially during sepsis. Competing Interests: The authors declare no conflict of interest. (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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