Clinical characteristics of chemotherapy-induced alopecia in childhood.

Abstract

Chemotherapy-induced alopecia (CIA) is a frequent complication in patients with cancer. There are an increasing number of reports of permanent CIA. We investigated the clinical characteristics of CIA, including permanent CIA in childhood. We collected data on 159 pediatric patients who had undergone high-dose conditioning chemotherapy followed by hematopoietic stem cell transplantation and 167 control subjects, using a questionnaire, medical record reviews, and phototrichograms. Alopecia began at 1.5 ± 1.4 months and was sustained until 2.2 ± 1.6 months after chemotherapy initiation. Hair regrowth started 2.6 ± 1.6 months after chemotherapy ceased and lasted for 7.3 ± 4.9 months. The mean hair density and thickness were 198.3 ± 47.4/cm(2) and 76.3 ± 18.4 μm in the patient group and 229.6 ± 34.5/cm(2) and 79.5 ± 12.4 μm in the control group, respectively (both, P < .001). In all, 19 (12%) patients experienced permanent CIA. Thiotepa use was identified as a significant risk factor for permanent CIA (odds ratio 7.57, P = .002). Cross-sectional study in a single-center is a limitation. CIA is common in pediatric patients. Use of thiotepa is strongly associated with permanent CIA.