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Abdominal Complications During Treatment for Pediatric Acute Myeloid Leukemia

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  • Sofie E Borgstedt-Bendixen
  • Jonas Abrahamsson
  • Shau-Yin Ha
  • Minna Koskenvuo
  • Birgitte Lausen
  • Josefine Palle
  • Bernward Zeller
  • Henrik Hasle
  • Ditte J A Løhmann
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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.

Original languageEnglish
JournalJournal of Pediatric Hematology/Oncology
Volume44
Issue number5
Pages (from-to)220-229
Number of pages10
ISSN1077-4114
DOIs
Publication statusPublished - 1 Jul 2022

Bibliographical note

Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

    Research areas

  • Appendicitis/etiology, Child, Hematopoietic Stem Cell Transplantation/adverse effects, Hepatic Veno-Occlusive Disease/etiology, Humans, Hyperbilirubinemia/etiology, Leukemia, Myeloid, Acute/complications, Retrospective Studies, Sepsis/etiology

ID: 79439549