Publication: Acute pancreatitis in children with acute lymphoblastic leukemia after chemotherapy
Issued Date
2009-11-01
Resource Type
ISSN
15363678
10774114
10774114
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2-s2.0-74249109508
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Mahidol University
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SCOPUS
Bibliographic Citation
Journal of Pediatric Hematology/Oncology. Vol.31, No.11 (2009), 812-815
Suggested Citation
Suporn Treepongkaruna, Naporn Thongpak, Samart Pakakasama, Paneeya Pienvichit, Nongnuch Sirachainan, Suradej Hongeng Acute pancreatitis in children with acute lymphoblastic leukemia after chemotherapy. Journal of Pediatric Hematology/Oncology. Vol.31, No.11 (2009), 812-815. doi:10.1097/MPH.0b013e3181b87035 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/27868
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Title
Acute pancreatitis in children with acute lymphoblastic leukemia after chemotherapy
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Abstract
Background: Acute pancreatitis (AP) is a complication in children with acute lymphoblastic leukemia (ALL) receiving chemotherapy and has often been reported associated with L-asparaginase (L-asp) therapy. Objectives: To determine the incidence, risk factors, clinical data, outcome, and mortality of AP in children with ALL. Methods: Retrospective cohort study was conducted by reviewing the data of total 192 pediatric ALL patients from Pediatric Oncology Registry at Ramathibodi Hospital from 2000 to 2006 to assess incidence, clinical data, outcome, and mortality of AP. Then, a nested case-control study was conducted to identify potential risk factors for AP by recruiting all patients with AP as cases (n=16), and randomly selected patients without AP to serve as controls up to approximately four controls per case with the total of 68 controls. Results: The total incidence of AP in children with ALL and L-asp-associated AP was 8.3% and 7.3%, respectively. In patients with L-asp-associated AP, pancreatitis developed after the median 5.5 doses (range: 1 to 20 doses) of L-asp therapy and the median interval from the last dose of L-asp to the onset of AP was 4 days (range: 1 to 13 days). The mortality rate of AP group was significantly higher than the patients without AP (43.8% vs. 19.3%, P=0.02). Mortality was associated with concurrent systemic infection and complications of underlying diseases. Multivariate analysis identified using a high-risk chemotherapy regimen was the only risk factor for AP. Conclusions: Using a high-risk chemotherapy regimen was a risk factor for pancreatitis in patients with ALL. ALL children with AP had higher mortality rate than those without pancreatitis. Copyright © 2009 by Lippincott Williams & Wilkins.