Acute myeloid leukemia (AML) accounts for 15% to 20% of childhood leukemias. Because of high-intensive therapy, up to 5% of patients suffer from treatment-related mortality (TRM). Abdominal complications are frequent, however, literature on this subject is sparse. We aimed to characterize severe abdominal pain (AP) and hyperbilirubinemia experienced by pediatric AML patients treated according to the Nordic Society of Pediatric Hematology and Oncology (NOPHO)-AML 2004 protocol (n=313). Patients were censored at hematopoietic stem cell transplantation and relapse. Toxicity information was collected prospectively. Additional information was requested retrospectively from the treating centers. Sixteen episodes of hyperbilirubinemia and 107 episodes of AP were reported. The treating centers deemed infection (30%) and typhlitis (18%) as the most frequent causes of AP. Six patients developed appendicitis (2%). Patients experiencing concurrent AP and sepsis had a high risk of TRM (36%, n=4). Eighty percent of episodes with hyperbilirubinemia fulfilled the European Society for Bone and Marrow Transplantation criteria for sinusoidal obstruction syndrome. In conclusion, abdominal complications were frequent with infection considered the predominate cause. Most patients with hyperbilirubinemia fulfilled the criteria for sinusoidal obstruction syndrome. AML treatment might be associated with appendicitis. Patients suffering from concurrent AP and sepsis had a high risk of TRM indicating that high awareness of abdominal complications is essential to reduce mortality, especially during sepsis.

急性髓性白血病 (AML) 占儿童白血病的 15% 至 20%。由于高强度治疗，高达 5% 的患者遭受治疗相关死亡率 (TRM)。腹部并发症很常见，然而，关于这个主题的文献很少。我们旨在描述根据北欧儿科血液和肿瘤学会 (NOPHO)-AML 2004 协议 (n=313) 治疗的儿科 AML 患者所经历的严重腹痛 (AP) 和高胆红素血症。患者在造血干细胞移植和复发时被审查。前瞻性收集毒性信息。回顾性要求治疗中心提供更多信息。报告了 16 次高胆红素血症和 107 次 AP。治疗中心认为感染 (30%) 和伤寒 (18%) 是 AP 的最常见原因。六名患者出现阑尾炎（2%）。并发 AP 和脓毒症的患者发生 TRM 的风险很高（36%，n=4）。80% 的高胆红素血症事件符合欧洲骨髓移植协会的标准窦性阻塞综合征。总之，腹部并发症很常见，感染被认为是主要原因。大多数高胆红素血症患者符合肝窦阻塞综合征的标准。AML 治疗可能与阑尾炎有关。患有并发 AP 和脓毒症的患者发生 TRM 的风险很高，这表明对腹部并发症的高度认识对于降低死亡率至关重要，尤其是在脓毒症期间。