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Hispanic Children Hospitalized With Acute Lymphoblastic Leukemia Are at Increased Risk of Pancreatitis
Beth Savage1, Peter D Cole, Haiqun Lin
1Author Affiliations: Rutgers University School of Nursing, Newark (Drs Savage, Lin, and Thomas-Hawkins); Rutgers Cancer Institute of New Jersey, New Brunswick (Dr Cole), NJ.
Insights
Hispanic children with acute lymphoblastic leukemia face a higher risk of pancreatitis. This finding highlights potential genetic and social factors contributing to this disparity in pediatric cancer treatment.
Area of Science:
- Pediatric Oncology
- Hematology
- Clinical Research
Background:
- Childhood acute lymphoblastic leukemia (ALL) survival has improved, yet treatment toxicities like pancreatitis persist.
- Pancreatitis often occurs early in ALL treatment, suggesting pre-existing risk factors beyond chemotherapy exposure.
- The influence of race and ethnicity on treatment-related pancreatitis in pediatric ALL is not well understood.
Purpose of the Study:
- To investigate the association between race/ethnicity and pancreatitis incidence in children diagnosed with ALL in the U.S.
- To identify potential disparities in pancreatitis risk among diverse pediatric populations undergoing ALL treatment.
Main Methods:
- Analysis of a national pediatric hospitalization database (21,775 ALL cases).
- Descriptive statistics, chi-squared tests, and multilevel logistic regression models were employed.
- Examined hospital discharge records for documented pancreatitis diagnoses.
Main Results:
- Pancreatitis was identified in 1.6% of pediatric ALL hospitalizations.
- Hispanic children demonstrated a significantly increased risk of pancreatitis compared to white children (P = .002).
- No significant differences in pancreatitis risk were observed for Black, Asian, or other racial/ethnic groups.
Conclusions:
- Hispanic children hospitalized with ALL exhibit a heightened risk of developing pancreatitis.
- This disparity may stem from a combination of genetic predispositions and socioeconomic factors.
- Further research into diverse patient populations is crucial for understanding and mitigating ALL treatment toxicities.
Background:
There have been remarkable advances in overall survival following the diagnosis of acute lymphoblastic leukemia in childhood, but toxicities, including pancreatitis, remain a concern. Pancreatitis occurs early in therapy, before extensive exposure to the chemotherapy agents associated with its development, indicating there are underlying risk factors for some children. The role of race/ethnicity in treatment-related pancreatitis has not been well established.
Objective:
The aim of this study was to examine the relationship between race/ethnicity and pancreatitis in children hospitalized with acute lymphoblastic leukemia in the United States in 2016.
Methods:
This was an analysis of a nationally representative database of pediatric hospitalizations. The sample consisted of 21 775 records with documentation of the diagnosis of acute lymphoblastic leukemia. Statistical methods included descriptive statistics, bivariate analyses using the χ2 test, and multilevel logistic regression models.
Results:
Pancreatitis was documented in 1.6% of hospital discharges. Compared with white children, Hispanic children were at increased risk of pancreatitis during hospitalization (P = .002). There were no differences among black (P = .469), Asian (P = .364), or other-race children (P = .937).
Conclusions:
Hispanic children hospitalized with acute lymphoblastic leukemia are at greater risk of pancreatitis than white children. Reasons for this disparity are likely due to both genetic and social factors.
Implications For Practice:
Nurses must be active participants in the research process with the goal of enrolling patients with diverse backgrounds in clinical trials. Inclusive research will provide increased understanding of a holistic toxicity risk profile.
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