Virginia Via Research Day Book 2026

Medical Student Research Clinical 28

IDENTIFYING TREATMENT-RELATED RISK PATTERNS FOR CHEMOTHERAPY-INDUCED ALOPECIA IN CHILDREN AND ADOLESCENTS WITH CANCER

Laurel Ness, BS, MSc, OMS-II; Marlin Yacoub, BS, MSc, OMS-II; Moriah Zarzar, BS, MSc, OMS-II; James E Mahaney, PhD Corresponding author: lness@vcom.edu

VCOM-Virginia, Blacksburg, Virginia

developing CIA. This large-scale analysis aims to examine how different chemotherapeutic drug classes, individual agents, and treatment combinations relate to the onset and severity of CIA in children and adolescents. An additional aim is to explore whether demographic or clinical characteristics (such as age, sex, cancer type, treatment duration, or cumulative drug exposure) modify the risk of CIA. By identifying treatment-related risk patterns, this work seeks to inform improved pediatric clinical guidance, support advocacy for standardized interventions, and strengthen counseling practices. The core hypothesis is that specific chemotherapeutic categories, particularly those known to target rapidly proliferating tissues, will be associated with a significantly increased risk of alopecia, and that these patterns can be reliably detected within the All of Us dataset. Methods: This study will employ a retrospective cohort design using de-identified pediatric cancer patient data from the All of Us Research Program. Information on chemotherapy exposures, including drug classes, individual names, dosage categories, and treatment timelines, will be extracted using standardized electronic health record terminology. Additional variables will include demographic data, primary cancer diagnoses, treatment combinations, and documented presence or absence of alopecia. Data cleaning and preprocessing

will ensure consistent definitions of exposures and outcomes. Descriptive statistics will characterize the study population, followed by multivariable logistic regression analyses to estimate associations between specific chemotherapeutic agents or regimens and the development of CIA. The overall methodological approach is intended to generate clinically meaningful insights into patterns of CIA risk across different treatment types. Results: Results are currently in progress. Planned analyses will report CIA prevalence, identify high-risk chemotherapeutic exposures, and provide adjusted odds ratios with confidence intervals. Conclusion: Final conclusions will synthesize identified associations to support improved pediatric guidance and potential intervention strategies.

Context: Chemotherapy-induced alopecia (CIA) is a highly prevalent and psychologically distressing side effect experienced by children and adolescents undergoing cancer treatment. Cytotoxic chemotherapy agents, such as alkylating agents, antimetabolites, antimicrotubular agents, and topoisomerase inhibitors, indiscriminately target rapidly dividing cells, including hair matrix cells, leading to varying degrees of hair loss. CIA negatively impacts quality of life, impairs self-esteem, and can contribute to bullying, social withdrawal, and emotional distress. Current pediatric clinical guidance is limited to supportive measures, and emerging interventions like scalp cooling and low dose minoxidil lack standardized recommendations. A large-scale, systemic evaluation is missing to determine how individual agents, dose categories, and complex treatment combinations in pediatric oncology relate to the onset and severity of CIA. This research gap hinders the development of standardized pediatric recommendations for prophylaxis, counseling, and interventions. This project aims to address this by utilizing data from the All of Us Database. Objective/Hypothesis: The primary objective is to use the extensive and diverse dataset from the All of Us Research Program to evaluate the relationship between specific chemotherapy treatments administered to pediatric cancer patients and the likelihood of

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199 2026 Research Recognition Day