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Cisplatin in children: hearing loss correlates with iris and skin pigmentation
N W Todd1, C S Alvarado, D B Brewer
1Department of Surgery (Otolaryngology), Emory University School of Medicine, Atlanta, Georgia, USA.
Insights
Children with darker irises experienced significantly worse high-frequency hearing loss after cisplatin treatment compared to those with lighter irises. This suggests iris color may influence cisplatin ototoxicity susceptibility.
Area of Science:
- Ototoxicity research
- Pediatric oncology
- Genetics and pharmacology
Background:
- Cisplatin chemotherapy is a known cause of ototoxicity (hearing damage).
- Previous studies in adults suggest a link between iris pigmentation and cisplatin-induced hearing loss, with darker irises associated with worse outcomes.
- The effect of pigmentation on ototoxicity in pediatric patients receiving cisplatin has not been well-established.
Purpose of the Study:
- To investigate the association between iris pigmentation and the severity of cisplatin-induced hearing loss in children.
- To determine if children with darker irises experience greater deterioration in auditory thresholds compared to those with lighter irises.
Main Methods:
- Observational retrospective study.
- Analysis of auditory thresholds at 4000 Hz in 19 pediatric patients treated with cisplatin.
- Correlation analysis (Spearman's rank correlation) between iris color (categorized as blue/hazel vs. brown/black) and hearing loss.
Main Results:
- A weak but statistically significant correlation was found between high-frequency hearing loss (at 4000 Hz) and iris pigmentation (Spearman's r = 0.50; p < 0.05).
- Children with blue or hazel irises showed an average worsening of 2.9 dB at 4000 Hz.
- Children with brown or black irises experienced a significantly greater average worsening of 14.2 dB at 4000 Hz.
Conclusions:
- Iris pigmentation appears to be a factor influencing individual susceptibility to cisplatin-induced ototoxicity in children.
- The findings suggest that darker iris color is associated with more severe high-frequency hearing loss following cisplatin treatment.
- Iris color should be considered and reported in future studies assessing cisplatin-related hearing loss in pediatric populations.
Abstract:
Pigmentation is reported to affect cisplatin-induced ototoxicity in adult humans. The hearing loss is worse in people with brown irises, than in those with blue irises. We assessed the hypothesis that cisplatin-treated children with dark irises suffer more deterioration in auditory thresholds than do those with less pigmentation. For the 19 children whose data met the requirements of this observational retrospective study, we found a weak correlation (Spearman's r = 0.50; p < 0.05) of high frequency hearing loss (at 4000 Hz) and pigmentation. Blue or hazel-eyed children averaged 2.9 dB worsening at 4000 Hz, in contrast to 14.2 dB worsening for brown or black-eyed children. Pigmentation may account for some of the individual susceptibility to cisplatin ototoxicity. We suggest that iris colour be included in future reports of cisplatin-related hearing loss.