Predictors of Chemotherapy Induced Adverse Events in Pediatric Osteosarcoma Patients

Area of Science:

• Pediatric Oncology
• Clinical Pharmacology
• Chemotherapy Adverse Events

Background:

• Osteosarcoma is a primary bone malignancy affecting children and adolescents.
• Chemotherapy is a cornerstone of osteosarcoma treatment, but it is associated with significant adverse events.
• Understanding the prevalence and risk factors of these adverse events is crucial for optimizing treatment outcomes.

Purpose of the Study:

• To determine the incidence of chemotherapy-induced adverse events in pediatric osteosarcoma patients.
• To identify risk factors associated with these adverse events, particularly hepatotoxicity.
• To inform strategies for mitigating treatment toxicity in this population.

Main Methods:

• A retrospective cross-sectional study analyzed data from 90 pediatric osteosarcoma patients.
• Data encompassed 1,017 chemotherapy cycles administered between 2008 and 2018.
• Statistical analysis, including a generalized estimating equation model, was used to identify correlations between baseline characteristics and adverse events.

Main Results:

• The study identified high prevalence rates for anemia (70.69%), chemotherapy-induced nausea and vomiting (29.2%), neutropenia (26.65%), hepatotoxicity (21.2%), and thrombocytopenia (13.65%).
• Significant risk factors for chemotherapy-induced hepatotoxicity included methotrexate doses ≥ 12 g/m² (OR 1.30), plasma methotrexate concentration >0.1 μM at 72 hours (OR 1.22), and pre-hydration rate ≤ 125 mL/m²/h (OR 1.10).

Conclusions:

• Adverse events are common in pediatric osteosarcoma patients undergoing chemotherapy.
• Key risk factors for toxicity include higher chemotherapy doses, elevated methotrexate plasma levels, and slower pre-hydration rates.
• These findings can guide clinical practice to better manage and prevent chemotherapy-related toxicity in children with osteosarcoma.