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Pediatr Blood Cancer. 2017 Dec;64(12). doi: 10.1002/pbc.26712. Epub 2017 Jul 20.

Complications preceding early deaths in Black and White children with acute myeloid leukemia.

Winestone LE1,2,3,4, Getz KD1,2, Miller TP1,2,4, Li Y5, Huang YS6, Seif AE1,4, Fisher BT2,7,8, Aplenc R1,2,4,8.

Author information

1
Division of Oncology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
2
Center for Pediatric Clinical Effectiveness, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
3
Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania.
4
Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
5
Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
6
Healthcare Analytics Unit, Department of General Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
7
Division of Infectious Diseases, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
8
Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.

Abstract

Black patients have a twofold increased risk of induction mortality compared to White patients with acute myeloid leukemia (AML). We reviewed diagnosis and billing data from Pediatric Health Information System for 28 AML Induction I deaths to investigate conditions preceding death in White and Black patients. Half of deaths occurred within 10 days of initial diagnostic admission. Respiratory, cardiac, renal, and infectious complications were common prior to both White and Black deaths. Deaths in White patients were more commonly preceded by intracranial hemorrhage compared to deaths in Black patients. Future studies should assess management approaches of complications by race to identify modifiable processes that reduce mortality.

KEYWORDS:

AML; disparities; intensive care; mortality; outcomes research; race

PMID:
28727288
PMCID:
PMC5733774
DOI:
10.1002/pbc.26712
[Indexed for MEDLINE]
Free PMC Article

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