Identifying relapses and stem cell transplants in pediatric acute lymphoblastic leukemia using administrative data: Capturing national outcomes irrespective of trial enrollment
| Autor: | Jennifer J. Wilkes, Yuan-Shung V. Huang, Tamara P. Miller, Alix E. Seif, Amanda M. DiNofia, Karen R. Rabin, Kelly D. Getz, Lena E. Winestone, Brian T. Fisher, Yimei Li, Richard Aplenc, Caitlin W Elgarten, Viviane C. Cahen, M. Monica Gramatges |
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| Rok vydání: | 2020 |
| Předmět: |
Pediatrics
medicine.medical_specialty medicine.medical_treatment Hematopoietic stem cell transplantation CHOP 03 medical and health sciences 0302 clinical medicine Pediatric Acute Lymphoblastic Leukemia Recurrence Risk Factors hemic and lymphatic diseases Chart review medicine Humans Child business.industry Incidence (epidemiology) Hematopoietic Stem Cell Transplantation Hematology Precursor Cell Lymphoblastic Leukemia-Lymphoma United States Clinical trial Oncology 030220 oncology & carcinogenesis Insurance status Pediatrics Perinatology and Child Health Cohort business 030215 immunology |
| Zdroj: | Pediatric Blood & Cancer. 68 |
| ISSN: | 1545-5017 1545-5009 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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