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dc.contributor.authorLøhmann, Ditte J A
dc.contributor.authorAbrahamsson, Jonas
dc.contributor.authorHa, Shau-Yin
dc.contributor.authorJónsson, Ólafur G
dc.contributor.authorKoskenvuo, Minna
dc.contributor.authorLausen, Birgitte
dc.contributor.authorPalle, Josefine
dc.contributor.authorZeller, Bernward
dc.contributor.authorHasle, Henrik
dc.date.accessioned2016-08-25T11:38:29Z
dc.date.available2016-08-25T11:38:29Z
dc.date.issued2016-07-28
dc.date.submitted2016
dc.identifier.citationEffect of age and body weight on toxicity and survival in pediatric acute myeloid leukemia: results from NOPHO-AML 2004.Haematologica. 2016, 101(11):1359-1367en
dc.identifier.issn1592-8721
dc.identifier.pmid27470605
dc.identifier.doi10.3324/haematol.2016.146175
dc.identifier.urihttp://hdl.handle.net/2336/618815
dc.descriptionTo access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Files. This article is open access.en
dc.description.abstractTreatment 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)). 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 2-9 (64% versus 76%, p=0.07). Infants showed a trend for superior 5-year event-free survival (66% versus 43%, p=0.06). Overweight children aged 10-17 showed a trend for superior survival (5-year event-free survival 59% versus 40%, p=0.09 and 5-year overall survival 78% versus 56%, p=0.06) compared to healthy weight children aged 10-17. In conclusion children aged 10-17 and overweight children had a higher risk of grade 3-4 toxicity. Children aged 10-17 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.
dc.languageENG
dc.language.isoenen
dc.publisherPaviaen
dc.relation.urlhttp://dx.doi.org/ 10.3324/haematol.2016.146175en
dc.rightsArchived with thanks to Haematologicaen
dc.subjectBráðahvítblæðien
dc.subjectPED12
dc.subject.meshLeukemia, Myeloid, Acuteen
dc.subject.meshAge Factorsen
dc.subject.meshBody Mass Indexen
dc.subject.meshChilden
dc.subject.meshChild, Preschoolen
dc.titleEffect of age and body weight on toxicity and survival in pediatric acute myeloid leukemia: results from NOPHO-AML 2004.en
dc.typeArticleen
dc.contributor.department1Aarhus University Hospital; dadolfsen@gmail.com. 2Queen Silvia Childrens Hospital, Gothenburg, Sweden; 3Queen Mary Hospital and Hong Kong Pediatric Hematology & Oncology Study Group (HKPHOSG), Hong Kong,; 4Landspitalinn, Reykjavik, Iceland; 5Childrens Hospital and Helsinki University Central Hospital, Helsinki, Finland; 6Rigshospitalet, University of Copenhagen, Denmark; 7Uppsala University, Uppsala, Sweden; 8Oslo University Hospital, Oslo, Norway; 9Aarhus University Hospital Skejby, Denmark.en
dc.identifier.journalHaematologicaen
dc.rights.accessOpen Accessen
html.description.abstractTreatment 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)). 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 2-9 (64% versus 76%, p=0.07). Infants showed a trend for superior 5-year event-free survival (66% versus 43%, p=0.06). Overweight children aged 10-17 showed a trend for superior survival (5-year event-free survival 59% versus 40%, p=0.09 and 5-year overall survival 78% versus 56%, p=0.06) compared to healthy weight children aged 10-17. In conclusion children aged 10-17 and overweight children had a higher risk of grade 3-4 toxicity. Children aged 10-17 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.


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