Risk factors for readmission after initial diagnosis in children with acute lymphoblastic leukemia

Background. Specific hospital discharge criteria following the initial diagnosis of children with acute lymphoblastic leukemia (ALL) have not been reported. This retrospective cohort study was designed to identify risk factors for readmission during induction therapy, to assist with development of discharge guidelines. Procedure. We reviewed the records of 142 consecutive children with newly diagnosed B-precursor ALL and found 129 eligible patients. Chi square, t-test, and multivariate logistic regression analysis were used to compare differences in absolute neutrophil count (ANC), NCI risk status, age, type of corticosteroid administered, and other potential risk factors for readmission during induction therapy. Results. ANC at initial hospital discharge was the only significant predictor of readmission for fever during induction therapy (P = 0.006) by multivariate analysis. Specifically an ANC ≤200/mm³ at discharge had the strongest association with readmission for fever (OR 3.3, 95% CI 1.422, 7.729). Conclusion. An ANC >200/mm³, in a clinically stable patient, is associated with minimal risk of readmission during induction therapy following the initial diagnosis of ALL.