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.<Table Float="No" ID="Taba"> <tgroup cols="2"> <colspec align="left" colname="c1" colnum="1" /> <colspec align="left" colname="c2" colnum="2" /> <tbody> <row> <entry nameend="c2" namest="c1"> 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. </entry> </row> </tbody> </tgroup> </Table>

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

期刊论文
发表日期：

2025年2月1日

查看全文

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

摘要

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.