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Risk factors for readmission after initial diagnosis in children with acute lymphoblastic leukemia
Author(s) -
Slone Tamra L.,
Rai Rachna,
Ahmad Naveed,
Winick Naomi J.
Publication year - 2008
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.21553
Subject(s) - medicine , logistic regression , multivariate analysis , retrospective cohort study , cohort , induction therapy , lymphoblastic leukemia , pediatrics , leukemia , chemotherapy
Background Specific hospital discharge criteria following the initial diagnosis of children with acute lymphoblastic leukemia (ALL) have not been reported. This retrospective cohort study was designed to identify risk factors for readmission during induction therapy, to assist with development of discharge guidelines. Procedure We reviewed the records of 142 consecutive children with newly diagnosed B‐precursor ALL and found 129 eligible patients. Chi square, t ‐test, and multivariate logistic regression analysis were used to compare differences in absolute neutrophil count (ANC), NCI risk status, age, type of corticosteroid administered, and other potential risk factors for readmission during induction therapy. Results ANC at initial hospital discharge was the only significant predictor of readmission for fever during induction therapy ( P = 0.006) by multivariate analysis. Specifically an ANC ≤200/mm 3 at discharge had the strongest association with readmission for fever (OR 3.3, 95% CI 1.422, 7.729). Conclusion An ANC >200/mm 3 , in a clinically stable patient, is associated with minimal risk of readmission during induction therapy following the initial diagnosis of ALL. Pediatr Blood Cancer 2008;51:375–379. © 2008 Wiley‐Liss, Inc.