| Author/Editor | Fischer, Brian T.; Kavčič, Marko; Aplenc, Richard; Singh, Sonia; Huang, Yuan-Shung; Li, Yimei; Gregory, John; Walker, Dana; Seif, Alix E.; Kavčič, Marko; Aplenc, Richard | |
| Title | 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 | |
| Type | članek | |
| Vol. and No. | Letnik 61, št. 1 | |
| Publication year | 2014 | |
| Volume | str. 68-73 | |
| ISSN | 1545-5009 - Pediatric blood & cancer | |
| Language | eng | |
| Abstract | BACKGROUND: 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. PROCEDURE: 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. RESULTS: 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 (P = 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. CONCLUSIONS: The induction mortality for pediatric acute promyelocytic leukemia remains substantial with wide variation in ATRA administration and high rates of resource utilization. | |
| Keywords | APL ATRA induction mortality resource utilization retinoic acid syndrome |