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Treatment-related mortality in children with acute lymphoblastic leukaemia in a low-middle income country
Author(s):
1. Rahat-Ul-Ain: Department of Pediatric Hematology/Oncology and BMT, The Children's Hospital and Institute of Child Health,Lahore,Pakistan
2. Mahwish Faizan: Department of Pediatric Hematology/Oncology and BMT, The Children's Hospital and Institute of Child Health,Lahore,Pakistan
3. Wasila Shamim: Department of Pediatric Hematology/Oncology and BMT, The Children's Hospital and Institute of Child Health,Lahore,Pakistan
Abstract:
Objective: To determine the proportion of treatment-related mortality among mortalities of paediatric acute lymphoblastic leukaemia and to identify probable causes and risk factors. Methods: 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. Results: 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%). Signifi cant factors associated with treatment-related mortality were weight-for-age, immunophenotype, the reason for admission, and absolute neutrophil count (p<0.05). Conclusion: 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.
Page(s): 2373-2377
DOI: DOI not available
Published: Journal: Journal of Pakistan Medical Association, Volume: 71, Issue: 10, Year: 2021
Keywords:
Infection , Acute Lymphoblastic Leukaemia , Developing countries , Drugrelated side effects , Adverse reactions
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