Ototoxicity following pediatric hematopoietic stem cell transplantation: a prospective cohort study.

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 micromol/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 benefit from more intensive audiological monitoring following SCT.