1. Non-infectious chemotherapy-associated acute toxicities during childhood acute lymphoblastic leukemia therapy [version 1; referees: 3 approved]
- Author
-
Kjeld Schmiegelow, Klaus Müller, Signe Sloth Mogensen, Pernille Rudebeck Mogensen, Benjamin Ole Wolthers, Ulrik Kristoffer Stoltze, Ruta Tuckuviene, and Thomas Frandsen
- Subjects
Review ,Articles ,Adrenal Cortex ,Allergy & Hypersensitivity ,Bleeding & Coagulation Disorders ,Bone Biology, Osteoporosis & Other Diseases of Bone ,Cancer Therapeutics ,Genetics of the Immune System ,Medical Genetics ,Neuro-Endocrinology & Pituitary ,Pancreas ,Pediatric Hematology ,Pediatric Oncology ,Pharmacogenomics ,Pharmacokinetics & Drug Delivery ,Toxicology ,acute lymphoblastic leukaemia ,ALL ,chemotherapy ,side effects ,toxicities - Abstract
During chemotherapy for childhood acute lymphoblastic leukemia, all organs can be affected by severe acute side effects, the most common being opportunistic infections, mucositis, central or peripheral neuropathy (or both), bone toxicities (including osteonecrosis), thromboembolism, sinusoidal obstruction syndrome, endocrinopathies (especially steroid-induced adrenal insufficiency and hyperglycemia), high-dose methotrexate-induced nephrotoxicity, asparaginase-associated hypersensitivity, pancreatitis, and hyperlipidemia. Few of the non-infectious acute toxicities are associated with clinically useful risk factors, and across study groups there has been wide diversity in toxicity definitions, capture strategies, and reporting, thus hampering meaningful comparisons of toxicity incidences for different leukemia protocols. Since treatment of acute lymphoblastic leukemia now yields 5-year overall survival rates above 90%, there is a need for strategies for assessing the burden of toxicities in the overall evaluation of anti-leukemic therapy programs.
- Published
- 2017
- Full Text
- View/download PDF