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Effect of age and body weight on toxicity and sur vival in pediatric acute myeloid leukemia: results from NOPHO-AML 2004
Aarhus Univ, Hosp Skejby, Dept Pediat, Aarhus, Denmark..
Queen Silvia Childrens Hosp, Inst Clin Sci, Dept Pediat, Gothenburg, Sweden..
Queen Mary Hosp, Dept Pediat, Hong Kong, Hong Kong, Peoples R China.;HKPHOSG, Hong Kong, Hong Kong, Peoples R China..
Landspitalinn, Dept Pediat, Reykjavik, Iceland..
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2016 (English)In: Haematologica, ISSN 0390-6078, E-ISSN 1592-8721, Vol. 101, no 11, 1359-1367 p.Article in journal (Refereed) Published
Abstract [en]

Treatment for pediatric acute myeloid leukemia is very toxic and the association between outcome and age and Body Mass Index is unclear. We investigated effect of age and Body Mass Index on toxicity and survival in pediatric acute myeloid leukemia. We studied all patients who completed first induction course of NOPHO-AML 2004 (n= 318). Toxicity following induction and consolidation courses (n= 6) was analyzed. The probabilities of toxicity and death were determined using time-to-event analyses with Cox multivariate proportional hazard regression for comparative analyses. Age 10-17 years was associated with sepsis with hypotension [hazard ratio 2.3 (95% confidence interval 1.1-4.6)]. Being overweight (> 1 standard deviation) was associated with requiring supplemental oxygen [1.9 (1.0-3.5)]. The 5-year event-free and overall survival were 47% and 71%. Children aged 10-17 years showed a trend for inferior 5-year overall survival compared to children aged 29 (64% vs. 76%; P= 0.07). Infants showed a trend for superior 5-year event-free survival (66% vs. 43%; P= 0.06). Overweight children aged 10-17 years showed a trend for superior survival [5-year event-free survival 59% vs. 40% (P= 0.09) and 5-year overall survival 78% vs. 56% (P= 0.06)] compared to healthy weight children aged 10-17 years. In conclusion, children aged 10-17 years and overweight children had a higher risk of grade 3-4 toxicity. Children aged 10-17 years showed inferior survival, but, unexpectedly, in this age group overweight children tended to have increased survival. This suggests different pharmacokinetics of chemotherapeutic drugs in adolescents and warrants further studies.

Place, publisher, year, edition, pages
2016. Vol. 101, no 11, 1359-1367 p.
National Category
Hematology Cancer and Oncology Pediatrics
Identifiers
URN: urn:nbn:se:uu:diva-316452DOI: 10.3324/haematol.2016.146175ISI: 000392550200012PubMedID: 27470605OAI: oai:DiVA.org:uu-316452DiVA: diva2:1077856
Funder
Novo Nordisk
Available from: 2017-03-01 Created: 2017-03-01 Last updated: 2017-03-01Bibliographically approved

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Citation style
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