Steroid-induced Hypertension During Induction Chemotherapy for Acute Lymphoblastic Leukemia in US Children's Hospitals

J Pediatr Hematol Oncol. 2018 Jan;40(1):27-30. doi: 10.1097/MPH.0000000000000997.

Abstract

Childhood acute lymphoblastic leukemia achieves excellent cure rates in part due to induction chemotherapy including high dose corticosteroids. Hypertension (HTN) is a known complication of corticosteroids, but incidence and risk factors for steroid-induced HTN are poorly understood. We sought to describe these using a large pediatric health database. Of the 5578 unique patients receiving induction chemotherapy, 14.7% received anti-HTN medications during their initial hospital admission. We found that age below 1 year, obesity, secondary diabetes mellitus, and abnormal glucose were associated with developing steroid-induced HTN. We also found that ICD-9 codes had poor sensitivity for detecting treatment of HTN, suggesting underreporting by physicians.

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Age Factors
  • Blood Glucose / analysis
  • Child
  • Child, Preschool
  • Diabetes Mellitus
  • Female
  • Hospitals, Pediatric
  • Humans
  • Hypertension / chemically induced*
  • Induction Chemotherapy / methods*
  • Infant
  • Male
  • Obesity
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / epidemiology
  • Risk Factors
  • Steroids / adverse effects*
  • United States / epidemiology

Substances

  • Adrenal Cortex Hormones
  • Blood Glucose
  • Steroids