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Borgstedt-Bendixen SE, Abrahamsson J, Ha SY, et al. Abdominal Complications During Treatment for Pediatric Acute Myeloid Leukemia. J Pediatr Hematol Oncol. 2021;doi: 10.1097/MPH.0000000000002281.
Borgstedt-Bendixen, S. E., Abrahamsson, J., Ha, S. Y., Koskenvuo, M., Lausen, B., Palle, J., Zeller, B., Hasle, H., & Løhmann, D. J. A. (2021). Abdominal Complications During Treatment for Pediatric Acute Myeloid Leukemia. Journal of pediatric hematology/oncology, . https://doi.org/10.1097/MPH.0000000000002281
Borgstedt-Bendixen, Sofie E, et al. "Abdominal Complications During Treatment for Pediatric Acute Myeloid Leukemia." Journal of pediatric hematology/oncology vol. (2021). doi: https://doi.org/10.1097/MPH.0000000000002281
Borgstedt-Bendixen SE, Abrahamsson J, Ha SY, Koskenvuo M, Lausen B, Palle J, Zeller B, Hasle H, Løhmann DJA. Abdominal Complications During Treatment for Pediatric Acute Myeloid Leukemia. J Pediatr Hematol Oncol. 2021 Aug 16; doi: 10.1097/MPH.0000000000002281. Epub 2021 Aug 16. PMID: 34387627.
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J Pediatr Hematol Oncol. 2021 Aug 16; doi: 10.1097/MPH.0000000000002281. Epub 2021 Aug 16.

Abdominal Complications During Treatment for Pediatric Acute Myeloid Leukemia.

Journal of pediatric hematology/oncology

Sofie E Borgstedt-Bendixen, Jonas Abrahamsson, Shau-Yin Ha, Minna Koskenvuo, Birgitte Lausen, Josefine Palle, Bernward Zeller, Henrik Hasle, Ditte J A Løhmann

Affiliations

  1. Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark Department of Pediatrics, Institution for Clinical Sciences, Queen Silvia Children's Hospital, Gothenburg Department of Woman's and Children's Health, Uppsala University, Uppsala, Sweden Department of Pediatrics, Queen Mary Hospital and Hong Kong Pediatric Hematology and Oncology Study Group (HKPHOSG), Hong Kong, China Division of Hematology-Oncology and Stem Cell Transplantation, Children's Hospital and Helsinki University Central Hospital, Helsinki, Finland Department of Pediatrics and Adolescent Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.

PMID: 34387627 DOI: 10.1097/MPH.0000000000002281

Abstract

Acute myeloid leukemia (AML) accounts for 15% to 20% of childhood leukemias. Because of high-intensive therapy, up to 5% of patients suffer from treatment-related mortality (TRM). Abdominal complications are frequent, however, literature on this subject is sparse. We aimed to characterize severe abdominal pain (AP) and hyperbilirubinemia experienced by pediatric AML patients treated according to the Nordic Society of Pediatric Hematology and Oncology (NOPHO)-AML 2004 protocol (n=313). Patients were censored at hematopoietic stem cell transplantation and relapse. Toxicity information was collected prospectively. Additional information was requested retrospectively from the treating centers. Sixteen episodes of hyperbilirubinemia and 107 episodes of AP were reported. The treating centers deemed infection (30%) and typhlitis (18%) as the most frequent causes of AP. Six patients developed appendicitis (2%). Patients experiencing concurrent AP and sepsis had a high risk of TRM (36%, n=4). Eighty percent of episodes with hyperbilirubinemia fulfilled the European Society for Bone and Marrow Transplantation criteria for sinusoidal obstruction syndrome. In conclusion, abdominal complications were frequent with infection considered the predominate cause. Most patients with hyperbilirubinemia fulfilled the criteria for sinusoidal obstruction syndrome. AML treatment might be associated with appendicitis. Patients suffering from concurrent AP and sepsis had a high risk of TRM indicating that high awareness of abdominal complications is essential to reduce mortality, especially during sepsis.

Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

Conflict of interest statement

The authors declare no conflict of interest.

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