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TOPLINE:

In a cohort study, 49% of children treated with antiseizure medications (ASMs) developed leucopenia. Most episodes (88%) were mild, with no life-threatening episodes or deaths reported.

METHODOLOGY:

• Researchers conducted a retrospective, real-world cohort study including 198 patients younger than 18 years treated with ASMs at a hospital in Sweden.
• Patient characteristics and medical history were obtained from electronic medical records.
• Patient trajectories were followed for a median of 1207 days. The outcome was the occurrence of leucopenia in the cohort, classified as mild or deeper (moderate, severe, and life-threatening).
• More than 85% of patients had approximately quarterly blood count checks, and the frequency was increased when leucopenia was detected.

TAKEAWAY:

• Among the cohort, 49% of patients developed at least one episode of leucopenia, with 88%, 11%, 1%, and 0% of episodes being mild, moderate, severe, and life-threatening, respectively.
• Interventions such as switching and tapering of ASMs were required in only 2% and 2% of episodes, respectively.
• Risk factors for leucopenia development included dysfunction in other organ systems, longer treatment duration, ASM combination treatments, and slightly older age (mean difference, 2 years; P = .03).
• Leucopenia symptoms occurred in 3% of episodes. Low counts of other blood cell types were more frequent in the leucopenia group than in the non-leucopenia group (62% vs 18%; P < .001).

IN PRACTICE:

"Leucopenia is a far more common side-effect of ASM treatment than earlier believed. There is rarely a need for ASM adjustments in order to treat leucopenia," the authors wrote.

SOURCE:

This study was led by Hanna Pettersson, MSc, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden. It was published online on April 17, 2025, in The Journal of Pediatrics.

LIMITATIONS:

This retrospective study was limited by non-standardised testing and variable data availability between patients as blood count monitoring depended on clinical decisions and treatment duration. Most patients had frequent testing, but some patients had sparse data. Additionally, the study sample consisted mainly of European descent patients, potentially limiting the generalisability of the findings to other populations.

DISCLOSURES:

This study was supported by unrestricted grants from the Center for Innovative Medicine/Region Stockholm, the Swedish Childhood Cancer Foundation, CSL Behring, Takeda Pharmaceuticals, and the Margarethahemmet Association. The authors reported having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.