Ototoxicity following pediatric hematopoietic stem cell transplantation: A prospective cohort study

Authors

  • Angela Punnett MD, FRCPC,

    1. Department of Pediatrics, University of Toronto, Ontario, Canada
    2. Division of Hematology/Oncology, The Hospital for Sick Children, Ontario, Canada
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  • Bonnie Bliss BA, MA,

    1. Department of Otolaryngology, University of Toronto, Ontario, Canada
    2. Department of Communication Disorders, The Hospital for Sick Children, Ontario, Canada
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  • L. Lee Dupuis MScPhm, FCSHP,

    1. Faculty of Pharmacy, University of Toronto, Ontario, Canada
    2. Division of Hematology/Oncology, The Hospital for Sick Children, Ontario, Canada
    3. Department of Pharmacy, The Hospital for Sick Children, Ontario, Canada
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  • Mohamed Abdolell MSc,

    1. Department of Public Health Sciences, University of Toronto, Ontario, Canada
    2. Cancer Quality Council of Ontario Secretariat, Cancer Care Ontario, Canada
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  • John Doyle MD, FRCPC,

    1. Department of Pediatrics, University of Toronto, Ontario, Canada
    2. Division of Hematology/Oncology, The Hospital for Sick Children, Ontario, Canada
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  • Lillian Sung BA, MD, FRCPC

    Corresponding author
    1. Department of Pediatrics, University of Toronto, Ontario, Canada
    2. Department of Health Policy Management and Evaluation, University of Toronto, Ontario, Canada
    3. Division of Hematology/Oncology, The Hospital for Sick Children, Ontario, Canada
    • Division of Hematology/Oncology, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, M5G 1X8.
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Abstract

Background

Our objectives were to describe the frequency and determine risk factors for hearing deterioration following pediatric stem cell transplantation (SCT).

Methods

In this prospective cohort study, we performed pure tone audiometry and measured otoacoustic emissions (OAE) prior to and following SCT. Worse hearing was considered deterioration in either audiometry or OAE.

Results

Between October 2000 and November 2002, 45 informative audiometry or OAE results were obtained. Hearing deteriorated following SCT in 20/45 (44%) of these children. Those with worse hearing following SCT were more likely to have neuroblastoma (odds ratio [OR] 16.0 [95% CI 1.8, 143.2; P = 0.003]), receive carboplatin conditioning (OR 7.7 [95% CI 1.4, 41.9; P = 0.01]), have abnormal baseline hearing (OR 5.1 [95% CI 1.3, 19.5; P = 0.02]), and have higher baseline serum creatinine (OR for every increase of 5 μmol/L of serum creatinine of 1.5 [95% CI 1.03, 2.1; P = 0.03]).

Conclusion

Many children who undergo SCT will have deterioration in hearing following SCT. A high-risk group of children can be delineated who may bene fit from more intensive audiological monitoring following SCT. © 2004 Wiley-Liss, Inc.

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