Incidence and predictors of treatment-related conjugated hyperbilirubinemia during early treatment phases for children with acute lymphoblastic leukemia

Pediatr Blood Cancer. 2020 Feb;67(2):e28063. doi: 10.1002/pbc.28063. Epub 2019 Nov 17.

Abstract

Conjugated hyperbilirubinemia (CHB) and liver transaminase elevation are known complications of acute lymphoblastic leukemia (ALL) therapy, but host risk factors are poorly understood. Among 373 children diagnosed with ALL between 2011 and 2016, clinically significant CHB and transaminase elevation were observed in 15 (4.0%) and 12 (3.2%) children, respectively, during induction and consolidation. Body mass index ≥95th percentile (odds ratio 9.20, 95% confidence interval 2.56-32.96) was the only host factor independently associated with CHB, and no host factors were associated with transaminase elevation. Obese patients warrant closer monitoring of hepatic function to facilitate early intervention prior to the development of severe, adverse hepatic events.

Keywords: acute lymphoblastic leukemia; hepatotoxicity; hyperbilirubinemia; obesity; pediatric.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Biomarkers, Tumor / analysis*
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Humans
  • Hyperbilirubinemia / chemically induced
  • Hyperbilirubinemia / epidemiology*
  • Hyperbilirubinemia / metabolism
  • Hyperbilirubinemia / pathology
  • Incidence
  • Male
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / pathology
  • Prognosis
  • Risk Factors
  • Texas / epidemiology
  • Young Adult

Substances

  • Biomarkers, Tumor