Comprehensive analysis of myelosuppression of pediatric patients receiving radiotherapy

Abstract

Pediatric oncology management necessitates distinct strategies for radiotherapy due to the heightened sensitivity of pediatric bone marrow to radiation exposure compared to adults. Therefore, this study aimed to compare the risk of radiation-induced myelosuppression between pediatric and adult patients by analyzing the correlations between gender, age, active marrow distribution, and radiation-induced myelosuppression. The medical records of 49 pediatric patients aged <15 years were retrospectively analyzed. Subgroup analyses based on sex and age were conducted to compare this pediatric patient data with data from adult patients reported in the literature. The observed rate of radiation-induced myelosuppression in the pediatric group was 59.18%, which was approximately twice the rate for the adult group (34%) reported in literature. Notably, the rates of leukopenia and granulocytopenia were observed in 53% and 45% of patients suffering from radiation-induced myelosuppression, respectively, compared to rates of thrombocytopenia and hemoglobinopenia observed in only 10% of patients, indicating that white blood cells and granulocytes are more sensitive indicators of radiation-induced myelosuppression. Our findings revealed that pediatric patients receiving radiotherapy in the head-and-neck regions face a higher risk of radiation-induced myelosuppression than adult patients due to the changes in active bone marrow during childhood development. Therefore, careful consideration of radiation-induced myelosuppression is essential during protocol optimization for pediatric patients receiving radiotherapy outside the pelvic region.