Modeling Survival and Prognosis in Children and Adolescents with Hematological Malignancies with Liver Involvement Treated in Mardani-Azar Hospital, Tabriz

Abstract

Hepatic disorders have led to treatment delay and in some cases treatment interruption and resumption of treatment, in addition to the complications caused by the liver itself, it causes the recurrence of the underlying disease and imposes additional costs on the patient. By knowing these complications, children and teenagers can be helped more by prevention. This study aims to model survival and prognosis in children and adolescents with hematological malignancies with liver involvement treated at Mardani-Azar Hospital in Tabriz. Materials and Methods: This cross-sectional study was conducted in the hematology and oncology department of Zahra Mardani-Azar Children's Hospital, among the cases of children and adolescents with hematological malignancies admitted from January 1, 2022, to January 1, 2023. From the information in the file, data related to the patient's demographic information, type of malignancy, time of diagnosis, stage of treatment, drugs used in the chemotherapy regimen and their dosage, and the results of tests related to liver complications before and after receiving these drugs were extracted. Also, survival modeling was done by recording the clinical and laboratory course of the patient from the time of diagnosis to the occurrence of the outcome (including disease recurrence, disease remission, complete recovery, and mortality) and was analyzed based on the Kaplan Meier method. Results: In this study, out of 150 patients with hematological malignancies under treatment, 55 (36%) had liver enzyme disorders. All patients with elevated liver enzymes were normal before discharge. The survival rate in patients with liver complications was 87%, and one of the patients finally recovered completely, which was proven by BMA. The average length of stay in the ward was 22.8 days and the average length of stay in the hospital was 25.4 days. Five patients (9%) eventually died. In patients who had long-term persistent liver enzymes that led to long-term discontinuation of treatment, the mortality rate was significantly higher than in patients whose liver complications improved with or without treatment, and malignancy treatment was continued.