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儿童急性淋巴细胞白血病早期治疗期间与治疗相关的结合性高胆红素血症的发生率和预测因素。

Incidence and predictors of treatment-related conjugated hyperbilirubinemia during early treatment phases for children with acute lymphoblastic leukemia.

机构信息

Section of Hematology and Oncology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas.

Department of Pathology and Immunology, Baylor College of Medicine, Houston, Texas.

出版信息

Pediatr Blood Cancer. 2020 Feb;67(2):e28063. doi: 10.1002/pbc.28063. Epub 2019 Nov 17.

Abstract

Conjugated hyperbilirubinemia (CHB) and liver transaminase elevation are known complications of acute lymphoblastic leukemia (ALL) therapy, but host risk factors are poorly understood. Among 373 children diagnosed with ALL between 2011 and 2016, clinically significant CHB and transaminase elevation were observed in 15 (4.0%) and 12 (3.2%) children, respectively, during induction and consolidation. Body mass index ≥95th percentile (odds ratio 9.20, 95% confidence interval 2.56-32.96) was the only host factor independently associated with CHB, and no host factors were associated with transaminase elevation. Obese patients warrant closer monitoring of hepatic function to facilitate early intervention prior to the development of severe, adverse hepatic events.

摘要

结合胆红素血症 (CHB) 和肝转氨酶升高是急性淋巴细胞白血病 (ALL) 治疗的已知并发症,但宿主危险因素了解甚少。在 2011 年至 2016 年间诊断出的 373 名 ALL 患儿中,分别有 15 名 (4.0%)和 12 名 (3.2%)患儿在诱导和巩固期间出现临床显著的 CHB 和转氨酶升高。体质指数≥第 95 百分位数 (比值比 9.20,95%置信区间 2.56-32.96) 是唯一与 CHB 相关的宿主因素,而没有宿主因素与转氨酶升高相关。肥胖患者需要更密切地监测肝功能,以便在发生严重不良肝脏事件之前进行早期干预。

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