Abstract 4930: Age and sex differences in the prevalence of specific comorbidities at diagnosis among pediatric acute lymphoblastic leukemia and lymphoblastic lymphoma patients
Authors: Xin Yang, Maua Mosha, Dave Bell, Jennifer Dean, Jennifer Mayer, Ernest K. Amankwah
Journal: Cancer Research (2025)

Abstract Introduction: Comorbidities affect treatment outcomes in adult cancer. However, limited knowledge exists on the prevalence of comorbidity among pediatric patients diagnosed with acute lymphoblastic leukemia (ALL) or lymphoblastic lymphoma (LL). The aim of this study was to determine the prevalence of comorbidities at diagnosis among pediatric ALL/LL patients, and to examine if the prevalence varied by age, biological sex at birth, and race/ethnicity. Methods: We analyzed data on patients diagnosed with ALL/LL at ≤21 years of age from 1/1/2005 to 6/30/2020 (n=5, 455), using data from the TriNetX Research Network that has de-identified patient-level data from electronic health records. All diagnoses were identified based on ICD-9-CM and ICD-10-CM. Comorbidities were categorized as pulmonary disease; cardiac disease; developmental disorder; vascular disease; cerebrovascular disease; immune disorder; metabolic disorder; infectious disease; genitourinary disease; digestive tract disease; muscle and connective tissue disease; and nervous system disease. Only comorbidities documented within three months prior to the initial ALL/LL diagnosis were included in the analysis. Results: Overall, 34.1% (n=1, 904) of patients had at least one comorbidity at diagnosis and 4.01% of the entire cohort (n=219) had ≥4 comorbidities. Females (36.6%) had a higher prevalence of overall comorbidity than males (33.6%) (p=0.024) and Non-Hispanic White patients (37.5%) had a higher prevalence of overall comorbidity than other racial/ethnic groups (33.1%) (p&amp;lt; 0.001). The most common comorbidities identified were digestive tract disease (n=667, 12.2%; 95%CI:11.4%-13.1%), muscle and connective tissue disease (n=523, 9.6%; 95%CI:8.8%-10.4%), metabolic disorders (n=513, 9.4%; 95%CI:8.6%-10.2%), nervous system diseases (n=466, 8.5%; 95%CI:7.8%-9.3%), and infectious diseases (n=446, 8.2%; 95%CI:7.4%-8.9%). Analyses of specific comorbidities revealed notable patterns based on sex at birth and age at ALL/LL diagnosis. Females exhibited a higher prevalence of infectious diseases (9.7% vs. 7.0%, p&amp;lt;0.001), digestive tract diseases (13.7% vs. 11.1%, p=0.005), and musculoskeletal conditions (11.0% vs. 8.6%, p=0.004) compared to males. Additionally, younger patients (≤10 years) had a higher prevalence (13.8%) of digestive diseases compared to those diagnosed after 10 years (10.4%, p&amp;lt;0.001). Conclusion: The overall prevalence of comorbidity among pediatric patients diagnosed with ALL/LL varies by biological sex at birth. Additionally, disparities exist for specific comorbidities, with females showing a higher prevalence of infectious diseases and younger patients having a higher prevalence of digestive tract diseases. Future studies are warranted to determine if these differences contribute to disparities in treatment outcomes. Citation Format: Xin Yang, Maua Mosha, Dave Bell, Jennifer Dean, Jennifer Mayer, Ernest K. Amankwah. Age and sex differences in the prevalence of specific comorbidities at diagnosis among pediatric acute lymphoblastic leukemia and lymphoblastic lymphoma patients [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 4930.