Department of Pediatric Hematology/Oncology and BMT, The Children's Hospital and Institute of Child Health, Lahore, Pakistan.
J Pak Med Assoc. 2021 Oct;71(10):2373-2377. doi: 10.47391/JPMA.796.
To determine the proportion of treatment-related mortality among mortalities of paediatric acute lymphoblastic leukaemia and to identify probable causes and risk factors.
The observational retrospective study was conducted in February-March 2019 at the Department of Paediatric Haematology-Oncology and Bone Marrow Transplant, the Children's Hospital and the Institute of Child Health, Lahore, Pakistan, and comprised data of all paediatric patients of acute lymphoblastic leukaemia who expired during treatment from January 2017 till September 2018. Death due to relapse and deaths before treatment were excluded. Data was analysed using SPSS 16.
Of the 247 deaths during the study period, 144(58.3%) were treatment-related mortality cases; 81(56.2%) males and 63(43.8%) females with an overall mean age of 5.0±3.83 years. The commonest cause was sepsis 126(87.5%), followed by haemorrhagic complications 11(7.6%), drug toxicity 4(2.8%), tumour lysis syndrome 2(1.4%) and thromboembolism 1(0.7%). Significant factors associated with treatment-related mortality were weight-for-age, immunophenotype, the reason for admission, and absolute neutrophil count (p<0.05).
Treatment-related mortality, though potentially avoidable, was found to be a major cause of death among paediatric patients of acute lymphoblastic leukaemia, and sepsis was the most common cause.
确定儿科急性淋巴细胞白血病死亡病例中与治疗相关的死亡率，并确定可能的原因和危险因素。
本观察性回顾性研究于 2019 年 2 月至 3 月在巴基斯坦拉合尔的儿童医院和儿童健康研究所的儿科血液肿瘤科进行，纳入了 2017 年 1 月至 2018 年 9 月期间在治疗期间死亡的所有急性淋巴细胞白血病儿科患者的数据。排除因复发和治疗前死亡的病例。使用 SPSS 16 对数据进行分析。
在研究期间，共有 247 例死亡病例，其中 144 例（58.3%）为治疗相关死亡率病例；男性 81 例（56.2%），女性 63 例（43.8%），平均年龄为 5.0±3.83 岁。最常见的死因是败血症 126 例（87.5%），其次是出血并发症 11 例（7.6%）、药物毒性 4 例（2.8%）、肿瘤溶解综合征 2 例（1.4%）和血栓栓塞 1 例（0.7%）。与治疗相关的死亡率相关的显著因素是体重与年龄的比值、免疫表型、入院原因和绝对中性粒细胞计数（p<0.05）。
尽管治疗相关的死亡率是可以避免的，但它仍是儿科急性淋巴细胞白血病患者死亡的主要原因，败血症是最常见的原因。
