open access

Vol 51, No 3 (2020)
ORIGINAL RESEARCH ARTICLE
Published online: 2020-09-01
Submitted: 2020-03-08
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Acute non-hematological toxicity of intensive chemotherapy of acute lymphoblastic leukemia in children

Ewa Demidowicz, Natalia Bartoszewicz, Krzysztof Czyżewski, Joanna Cisek, Anna Dąbrowska, Robert Dębski, Magdalena Dziedzic, Marlena Ewertowska, Elżbieta Grześk, Agnieszka Jatczak-Gaca, Andrzej Kołtan, Sylwia Kołtan, Anna Krenska, Monika Łęcka, Piotr Księżniakiewicz, Agata Marjańska, Monika Pogorzała, Monika Richert-Przygońska, Barbara Tejza, Anna Urbańczyk, Hanna Żołnowska, Mariusz Wysocki, Jan Styczyński
DOI: 10.2478/ahp-2020-0029
·
Acta Haematol Pol 2020;51(3):164-171.

open access

Vol 51, No 3 (2020)
ORIGINAL RESEARCH ARTICLE
Published online: 2020-09-01
Submitted: 2020-03-08

Abstract

Introduction

Leukemia belong to 31% of all childhood malignancies. Acute lymphoblastic leukemia (ALL) is the most frequent type of pediatric leukemia accounting for 80–85% of all cases. Progress in diagnostics and therapy of leukemia is dependent on international cooperation. The objective of the study was the analysis of non-hematological toxicity during intensive chemotherapy according to two consecutive intercontinental protocols.

Patients and methods

A total number of 210 children diagnosed for ALL who were treated in single center between 2002 and 2018 were divided in two groups defined by therapeutic protocol: ALL IC-BFM 2002 (group 1) and ALL IC-BFM 2009 (group 2). Data were entered prospectively from 2002 into international ALL IC-BFM 2002 and ALL IC-BFM 2009 registry. Non-hematological toxicity was analyzed according to the criteria followed in protocols, compatible with CTCAE criteria.

Results

The most frequent toxicities included hepatic toxicity with transaminitis and hyperbilirubinemia, infections, oral mucositis and gut toxicity with vomiting, and/or diarrhea. Non-hematological toxicity episodes calculated as a ratio per patient were comparably often observed in both the groups; however, the distribution was different. There were more grade III and less grade II toxicities. This was mainly related to significant increase in the rates of infections and transaminitis. However, there was a significant decrease in vomiting and central and peripheral neurotoxicity.

Conclusions

Intensive treatment of ALL is burdened with frequent severe toxic and infectious complications. Further progress in therapy of pediatric ALL is dependent on sophisticated supportive therapy and very well experienced and knowledgeable therapeutic team.

Abstract

Introduction

Leukemia belong to 31% of all childhood malignancies. Acute lymphoblastic leukemia (ALL) is the most frequent type of pediatric leukemia accounting for 80–85% of all cases. Progress in diagnostics and therapy of leukemia is dependent on international cooperation. The objective of the study was the analysis of non-hematological toxicity during intensive chemotherapy according to two consecutive intercontinental protocols.

Patients and methods

A total number of 210 children diagnosed for ALL who were treated in single center between 2002 and 2018 were divided in two groups defined by therapeutic protocol: ALL IC-BFM 2002 (group 1) and ALL IC-BFM 2009 (group 2). Data were entered prospectively from 2002 into international ALL IC-BFM 2002 and ALL IC-BFM 2009 registry. Non-hematological toxicity was analyzed according to the criteria followed in protocols, compatible with CTCAE criteria.

Results

The most frequent toxicities included hepatic toxicity with transaminitis and hyperbilirubinemia, infections, oral mucositis and gut toxicity with vomiting, and/or diarrhea. Non-hematological toxicity episodes calculated as a ratio per patient were comparably often observed in both the groups; however, the distribution was different. There were more grade III and less grade II toxicities. This was mainly related to significant increase in the rates of infections and transaminitis. However, there was a significant decrease in vomiting and central and peripheral neurotoxicity.

Conclusions

Intensive treatment of ALL is burdened with frequent severe toxic and infectious complications. Further progress in therapy of pediatric ALL is dependent on sophisticated supportive therapy and very well experienced and knowledgeable therapeutic team.

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Keywords

acute lymphoblastic leukemia; chemotherapy; toxicity; children

About this article
Title

Acute non-hematological toxicity of intensive chemotherapy of acute lymphoblastic leukemia in children

Journal

Acta Haematologica Polonica

Issue

Vol 51, No 3 (2020)

Pages

164-171

Published online

2020-09-01

DOI

10.2478/ahp-2020-0029

Bibliographic record

Acta Haematol Pol 2020;51(3):164-171.

Keywords

acute lymphoblastic leukemia
chemotherapy
toxicity
children

Authors

Ewa Demidowicz
Natalia Bartoszewicz
Krzysztof Czyżewski
Joanna Cisek
Anna Dąbrowska
Robert Dębski
Magdalena Dziedzic
Marlena Ewertowska
Elżbieta Grześk
Agnieszka Jatczak-Gaca
Andrzej Kołtan
Sylwia Kołtan
Anna Krenska
Monika Łęcka
Piotr Księżniakiewicz
Agata Marjańska
Monika Pogorzała
Monika Richert-Przygońska
Barbara Tejza
Anna Urbańczyk
Hanna Żołnowska
Mariusz Wysocki
Jan Styczyński

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