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Comparison of myelosuppression using the D-index between children and adolescents/young adults with acute lymphoblastic leukemia during induction chemotherapy
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  • Satoru Matsushima,
  • Ryoji Kobayashi,
  • Hirozumi Sano,
  • Daiki Hori,
  • Masato Yanagi,
  • Koya Kodama,
  • Daisuke Suzuki,
  • Kunihiko Kobayashi
Satoru Matsushima
Sapporo Hokuyu Hospital
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Ryoji Kobayashi
Sapporo Hokuyu hospital
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Hirozumi Sano
Sapporo Hokuyu Hospital
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Daiki Hori
Sapporo Hokuyu hospital
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Masato Yanagi
Sapporo Hokuyu Hospital
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Koya Kodama
Sapporo Hokuyu Hospital
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Daisuke Suzuki
Sapporo Hokuyu Hospital
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Kunihiko Kobayashi
Sapporo Hokuyu Hospital
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Abstract

Background. Adolescents/young adults (AYAs) with acute lymphoblastic leukemia (ALL) are more likely to have chemotherapy-related complications than children. In addition, several reports have shown that infections account for most of the therapy-related mortality during cancer treatment in AYAs. Thus, we hypothesized that chemotherapy-induced myelosuppression is more severe in AYAs than in children, and the state of neutropenia was compared between children and AYAs using the D-index, a numerical value calculated from the duration and depth of neutropenia. Procedure. This study retrospectively analyzed 95 patients newly diagnosed with ALL at our institution between 2007 and 2019. Of these, 81 were children (< 15 years old) and 14 were AYAs (≥ 15 years old). The D-index and duration of neutropenia during induction chemotherapy for ALL were compared between children and AYAs. Results. The median D-index of children was significantly higher than that of AYAs (8,187 vs. 6,446, respectively, P = 0.017). Moreover, the median duration of neutropenia was also significantly longer in children than in AYAs (24.0 days vs. 11.5 days, respectively, P = 0.007). Conclusion. Contrary to our expectations, myelosuppressive toxicity during induction chemotherapy for ALL was more severe in children than in AYAs.

Peer review status:UNDER REVIEW

06 Aug 2020Submission Checks Completed
06 Aug 2020Assigned to Editor
06 Aug 2020Submitted to Pediatric Blood & Cancer
07 Aug 2020Reviewer(s) Assigned
25 Aug 2020Review(s) Completed, Editorial Evaluation Pending
26 Aug 2020Editorial Decision: Revise Major
04 Sep 2020Submission Checks Completed
04 Sep 2020Assigned to Editor
04 Sep 20201st Revision Received
06 Sep 2020Reviewer(s) Assigned
19 Sep 2020Review(s) Completed, Editorial Evaluation Pending