Phase‐specific risks of outpatient visits, emergency visits, and hospitalizations during Children's Oncology Group‐based treatment for childhood acute lymphoblastic leukemia: A population‐based study

Background Therapy for childhood acute lymphoblastic leukemia (ALL) is associated with substantial health care utilization and burden on families. Little is known about health care utilization during specific treatment phases. Procedures We identified children with ALL diagnosed during 2002–2012 in...

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Bibliographic Details
Published in:Pediatric blood & cancer 2021-10, Vol.68 (10), p.e29141-n/a
Main Authors: Bassal, Mylene, Silva, Mariana, Patel, Serina, Gibson, Paul J., Breakey, Vicky R., Athale, Uma, Zabih, Veda, Li, Qing, Pechlivanoglou, Petros, Pole, Jason D., Mittmann, Nicole, Sutradhar, Rinku, Gupta, Sumit
Format: Article
Language:English
Subjects:
Acute lymphoblastic leukemia
Antineoplastic Combined Chemotherapy Protocols
burden of care
Child
Childhood
Children
Children & youth
Clinical trials
Dexamethasone
Dexamethasone - therapeutic use
emergency department
Emergency medical care
Emergency Service, Hospital - statistics & numerical data
health care utilization
Health services utilization
hospitalization
Hospitalization - statistics & numerical data
Humans
Leukemia
Lymphatic leukemia
Methotrexate
Methotrexate - therapeutic use
Oncology
Ontario - epidemiology
outpatient visits
Outpatients
Patients
Pediatrics
Population studies
Population-based studies
Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy
Precursor Cell Lymphoblastic Leukemia-Lymphoma - epidemiology
Prednisone
Prednisone - adverse effects
Steroid hormones
Toxicity
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Summary:Background Therapy for childhood acute lymphoblastic leukemia (ALL) is associated with substantial health care utilization and burden on families. Little is known about health care utilization during specific treatment phases. Procedures We identified children with ALL diagnosed during 2002–2012 in Ontario, Canada and treated according to Children's Oncology Group (COG) protocols. Disease and treatment data were chart ed. Population‐based health care databases identified all outpatient visits, emergency department (ED) visits, and hospitalizations. In addition to comparing standard and intensified versions of treatment phases, we compared patients receiving different steroids (dexamethasone vs. prednisone) and different versions of interim maintenance (IM) (Capizzi vs. high‐dose methotrexate [HD‐MTX]). Results Six hundred thirty‐seven children met inclusion criteria. During intensified consolidation, 76.2% of patients were hospitalized at least once, compared to only 32.3% of patients receiving standard consolidation (p 
ISSN:1545-5009
1545-5017
DOI:10.1002/pbc.29141