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.