Grade 3 and 4 Toxicity Profiles During Therapy of Childhood Acute Lymphoblastic Leukemia

Abstract

Background/aim: The risk factors, clinical features and non-hematological toxicity profiles during chemotherapy in acute lymphoblastic leukemia (ALL) patients treated in pediatric hematology centres were analysed.

Materials and methods: A total of 902/1872 children were reported as having grade 3 or 4 toxicity.

Results: Among the analysed toxicities, infection and gastrointestinal and liver toxicities were the most common. The median follow-up was 6.8 years. Overall survival and event-free survival rates for the analysed group were lower than those reported for the group without grade ≥3 toxicity. In univariate analysis, we identified the number of toxic episodes, the risk group and remission status that had a significant impact on the outcome. Multivariate analysis demonstrated the risk group and the number of toxic episodes ≥3 to be statistically significant for the results.

Conclusion: The toxic profiles investigated in our report should be used in future efforts to decrease the burden of side effects during chemotherapy.

Keywords: Acute lymphoblastic leukemia; chemotherapy; children; toxicity.