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Toxicity profile an...
Toxicity profile and treatment delays in NOPHO ALL2008-comparing adults and children with Philadelphia chromosome-negative acute lymphoblastic leukemia
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Toft, Nina (author)
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Birgens, Henrik (author)
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Abrahamsson, Jonas (author)
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Griškevičius, Laimonas (author)
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- Hallböök, Helene (author)
- Uppsala universitet,Hematologi
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- Heyman, Mats (author)
- Karolinska Institutet
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Klausen, Tobias Wirenfeldt (author)
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Jónsson, Ólafur Gísli (author)
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Palk, Katrin (author)
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Pruunsild, Kaie (author)
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Quist-Paulsen, Petter (author)
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Vaitkeviciene, Goda (author)
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Vettenranta, Kim (author)
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Asberg, Ann (author)
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Helt, Louise Rold (author)
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Frandsen, Thomas (author)
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Schmiegelow, Kjeld (author)
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(creator_code:org_t)
- 2015-04-24
- 2016
- English.
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In: European Journal of Haematology. - : Wiley. - 0902-4441 .- 1600-0609. ; 96:2, s. 160-169
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- OBJECTIVES: Cure rates improve when adolescents and young adults with acute lymphoblastic leukemia (ALL) are treated according to pediatric protocols. Assumed risks of toxicities and associated delays in treatment have played a role in setting upper age limits. The aim of this study was to examine the toxicity profile and treatment delays in NOPHO ALL2008 comparing children and adults.METHODS: We collected information on 19 treatment-related toxicities, systematically captured at 3-month intervals throughout therapy, and time intervals between 12 consecutive treatment phases for 1076 patients aged 1-45 yrs treated according to the Nordic/Baltic ALL2008 protocol.RESULTS: No adults died during induction. The duration of induction therapy and postinduction treatment phases did not differ between children and adults, except for patients 18-45 yrs being significantly delayed during two of nine high-risk blocks (median number of days for patients 1-9, 10-17, and 18-45 yrs; the glucocorticosteroid/antimetabolite-based block B1: 24, 26, and 29 d, respectively, P = 0.001, and Block 5 (in most cases also a B block): 29, 29, and 37 d, respectively, P = 0.02). A higher incidence of thrombosis with increasing age was found; highest odds ratio 5.4 (95% CI: (2.6;11.0)) for patients 15-17 yrs compared with children 1-9 yrs (P < 0.0001). Risk of avascular osteonecrosis was related to age with the highest OR for patients 10-14 yrs (OR = 10.4 (95% CI: (4.4;24.9)), P < 0.0001).CONCLUSION: Adults followed and tolerated the NOPHO ALL2008 protocol virtually as well as children, although thrombosis and avascular osteonecrosis was most common among adolescents.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Hematologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Hematology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
Keyword
- acute lymphoblastic leukemia; adults; children; treatment; toxicity
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Toft, Nina
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Birgens, Henrik
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Abrahamsson, Jon ...
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Griškevičius, La ...
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Hallböök, Helene
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Heyman, Mats
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show more...
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Klausen, Tobias ...
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Jónsson, Ólafur ...
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Palk, Katrin
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Pruunsild, Kaie
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Quist-Paulsen, P ...
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Vaitkeviciene, G ...
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Vettenranta, Kim
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Asberg, Ann
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Helt, Louise Rol ...
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Frandsen, Thomas
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Schmiegelow, Kje ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Hematology
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cancer and Oncol ...
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European Journal ...
- By the university
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Uppsala University
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Karolinska Institutet