Comparison of myelosuppression using the D-index between children and
adolescents/young adults with acute lymphoblastic leukemia during
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.