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. Issue 1 (18th July 2013)

• Record Type: Journal Article
• Authors: Fisher, Brian T.; Singh, Sonia; Huang, Yuan‐Shung; Li, Yimei; Gregory, John; Walker, Dana; Seif, Alix E.; Kavcic, Marko; Aplenc, Richard
• Is Part Of: Pediatric blood & cancer. Volume 61:Issue 1(2014:Jan.)
• Page Start: 68
• Page End: 73
• Publication Date: 2013-07-18
• Subjects: Tumors in children -- Periodicals; Blood -- Diseases -- Periodicals; Cancer in children -- Periodicals; 618.92
• DOI: 10.1002/pbc.24585
• Languages: English
• ISSNs: 1545-5009

Abstract

<abstract abstract-type="main" xml:lang="en"> <title>Abstract</title> <sec id="pbc24585-sec-0001" sec-type="section"> <title>Background</title> <p>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.</p> </sec> <sec id="pbc24585-sec-0002" sec-type="section"> <title>Procedure</title> <p>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.</p> </sec> <sec id="pbc24585-sec-0003" sec-type="section"> <title>Results</title> <p>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 (<italic>P</italic> = 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.</p> </sec> <sec id="pbc24585-sec-0004" sec-type="section"> <title>Conclusions</title> <p>The induction mortality for pediatric acute promyelocytic leukemia remains substantial with wide variation in ATRA administration and high rates of resource utilization. Pediatr Blood Cancer 2014;61:68–73. © 2013 Wiley Periodicals, Inc.</p> </sec> </abstract>