Incidence of and factors associated with hypophosphatemia in children and adolescents receiving cancer treatment: a single-center, retrospective study.

IF 2.6 3区医学 Q1 PEDIATRICS European Journal of Pediatrics Pub Date : 2025-02-01 DOI:10.1007/s00431-025-06002-1

Aoi Ogawa, Kenji Kishimoto, Shogo Horikawa, Suguru Uemura, Sayaka Hyodo, Aiko Kozaki, Atsuro Saito, Toshiaki Ishida, Takeshi Mori, Daiichiro Hasegawa, Yoshiyuki Kosaka

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Abstract

The aim of this study was to determine the incidence of hypophosphatemia and identify factors associated with high-risk hypophosphatemia in children and adolescents with cancer. Patients aged 0-18 years who developed hypophosphatemia during treatment for cancer in our hospital between January 2021 and March 2023 were enrolled. Hypophosphatemia was defined as a serum phosphorus level < 2.5 mg/dL. The high-risk group for symptomatic hypophosphatemia was defined as patients with a serum phosphorus level of 1.5-1.9 mg/dL lasting for 2 weeks or more and patients with a serum phosphorus level < 1.5 mg/dL. During the study period, 48 of 253 (19%) patients developed a total of 108 episodes of hypophosphatemia. Symptomatic episodes were more frequent in the high-risk group (n = 31; 84% vs. 39%). Elevated total bilirubin level (> 0.50 mg/dL) (adjusted odds ratio (OR), 3.60; 95% confidence interval (CI), 1.37-9.48) and stem cell transplantation (adjusted OR, 4.83; 95% CI, 1.69-13.81) were found to be potential baseline predictors of high-risk hypophosphatemia in the logistic regression model. Fasting, diarrhea, and vomiting after initiation of treatment were also associated with the development of high-risk hypophosphatemia.

Conclusions: The incidence of hypophosphatemia was relatively high in children and adolescents receiving treatment for cancer. The results suggest that baseline characteristics and therapy-related toxicities may be associated with the development of high-risk hypophosphatemia.

What is known: • Patients with cancer are at increased risk of hypophosphatemia in adults. • Hypophosphatemia may be a factor associated with a poor prognosis in hospitalized patients.

What is new: • The incidence of hypophosphatemia was relatively high in children and adolescents receiving treatment for cancer. • Both baseline characteristics and therapy-related factors may be associated with the development of high-risk hypophosphatemia.

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接受癌症治疗的儿童和青少年低磷血症的发生率及相关因素：一项单中心、回顾性研究

本研究的目的是确定儿童和青少年癌症患者低磷血症的发生率，并确定与高危低磷血症相关的因素。研究纳入了2021年1月至2023年3月在我院接受癌症治疗期间出现低磷血症的0-18岁患者。低磷血症定义为血清磷水平0.50 mg/dL(校正优势比（OR）， 3.60；95%可信区间（CI）， 1.37-9.48)和干细胞移植(调整OR， 4.83；95% CI, 1.69-13.81)在logistic回归模型中被发现是高危低磷血症的潜在基线预测因子。开始治疗后的禁食、腹泻和呕吐也与高风险低磷血症的发生有关。结论：低磷血症在接受癌症治疗的儿童和青少年中发病率较高。结果表明，基线特征和治疗相关的毒性可能与高风险低磷血症的发生有关。已知情况：•癌症患者在成人低磷血症的风险增加。•低磷血症可能是住院患者预后不良的一个相关因素。最新发现：•在接受癌症治疗的儿童和青少年中，低磷血症的发病率相对较高。•基线特征和治疗相关因素都可能与高风险低磷血症的发生有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Pediatrics 医学-小儿科

CiteScore

5.90

自引率

2.80%

发文量

367

审稿时长

3-6 weeks

期刊介绍： The European Journal of Pediatrics (EJPE) is a leading peer-reviewed medical journal which covers the entire field of pediatrics. The editors encourage authors to submit original articles, reviews, short communications, and correspondence on all relevant themes and topics. EJPE is particularly committed to the publication of articles on important new clinical research that will have an immediate impact on clinical pediatric practice. The editorial office very much welcomes ideas for publications, whether individual articles or article series, that fit this goal and is always willing to address inquiries from authors regarding potential submissions. Invited review articles on clinical pediatrics that provide comprehensive coverage of a subject of importance are also regularly commissioned. The short publication time reflects both the commitment of the editors and publishers and their passion for new developments in the field of pediatrics. EJPE is active on social media (@EurJPediatrics) and we invite you to participate. EJPE is the official journal of the European Academy of Paediatrics (EAP) and publishes guidelines and statements in cooperation with the EAP.