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Sökning: L773:2352 3026 > (2021) > Severe toxicity fre...

Severe toxicity free survival : physician-derived definitions of unacceptable long-term toxicities following acute lymphocytic leukaemia

Andrés-Jensen, Liv (författare)
Copenhagen Univ Hosp, Rigshosp, Dept Pediat & Adolescent Med, DK-2100 Copenhagen, Denmark
Attarbaschi, Andishe (författare)
Med Univ Vienna, St Anna Childrens Hosp, Dept Pediat Hematol Oncol, Vienna, Austria
Bardi, Edit (författare)
Med Univ Vienna, St Anna Childrens Hosp, Dept Pediat Hematol Oncol, Vienna, Austria; Kepler Univ Clin, Dept Pediat Oncol & Immunol, Linz, Austria
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Barzilai-Birenboim, Shlomit (författare)
Schneider Childrens Med Ctr Israel, Dept Pediat Hematol Oncol, Petah Tiqwa, Israel; Tel Aviv Univ, Sackler Fac Med, Tel Aviv, Israel
Bhojwani, Deepa (författare)
Univ Southern Calif, Keck Sch Med, Childrens Hosp Los Angeles, Dept Pediat,Norris Comprehens Canc Ctr, Los Angeles, CA 90007 USA
Hagleitner, Melanie M. (författare)
Princess Maxima Ctr Pediat Oncol, Utrecht, Netherlands
Halsey, Christina (författare)
Univ Glasgow, Coll Med Vet & Life Sci, Inst Canc Sci, Wohl Canc Res Ctr, Glasgow, Lanark, Scotland; Royal Hosp Children, Childrens Haematooncol Unit, Glasgow, Lanark, Scotland
Harila-Saari, Arja (författare)
Uppsala universitet,Barnneurologi/Barnonkologi
van Litsenburg, Raphaele R. L. (författare)
Princess Maxima Ctr Pediat Oncol, Utrecht, Netherlands
Hudson, Melissa M. (författare)
St Jude Childrens Res Hosp, Dept Oncol, 332 N Lauderdale St, Memphis, TN 38105 USA
Jeha, Sima (författare)
Kato, Motohiro (författare)
Univ Tokyo, Dept Pediat, Tokyo, Japan
Kremer, Leontien (författare)
Princess Maxima Ctr Pediat Oncol, Utrecht, Netherlands
Mlynarski, Wojciech (författare)
Med Univ Lodz, Dept Pediat Oncol & Hematol, Lodz, Poland
Möricke, Anja (författare)
Christian Albrechts Univ Kiel, Univ Med Ctr Schleswig Holstein, Dept Pediat, Kiel, Germany
Pieters, Rob (författare)
Princess Maxima Ctr Pediat Oncol, Utrecht, Netherlands
Piette, Caroline (författare)
Univ Hosp Liege, Dept Paediat, Liege, Belgium; Univ Liege, Liege, Belgium
Raetz, Elizabeth (författare)
NYU, Langone Med Ctr, Dept Pediat, New York, NY USA
Ronceray, Leila (författare)
Med Univ Vienna, St Anna Childrens Hosp, Dept Pediat Hematol Oncol, Vienna, Austria
Toro, Claudia (författare)
Royal Childrens Hosp, Murdoch Childrens Res Inst, Melbourne, Vic, Australia
Valsecchi, Maria Grazia (författare)
Univ Milan, Sch Med & Surg, Bicocca Ctr Bioinformat Biostat & Bioimaging, Monza, Italy
Vrooman, Lynda M. (författare)
Dana Farber Canc Inst, Dept Pediat Oncol, Boston, MA 02115 USA
Weinreb, Sigal (författare)
Hadassah Hebrew Univ, Med Ctr, Dept Pediat Hematol Oncol, Jerusalem, Israel
Winick, Naomi (författare)
Univ Texas Southwestern Med Ctr Dallas, Dallas, TX 75390 USA
Schmiegelow, Kjeld (författare)
Copenhagen Univ Hosp, Rigshosp, Dept Pediat & Adolescent Med, DK-2100 Copenhagen, Denmark; Univ Copenhagen, Fac Med, Inst Clin Med, Copenhagen, Denmark
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 (creator_code:org_t)
Elsevier, 2021
2021
Engelska.
Ingår i: The Lancet Haematology. - : Elsevier. - 2352-3026. ; 8:7, s. E513-E523
Relaterad länk:
https://urn.kb.se/re...
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https://doi.org/10.1...
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  • Forskningsöversikt (refereegranskat)
Abstract Ämnesord
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  • 5-year overall survival rates have surpassed 90% for childhood acute lymphocytic leukaemia, but survivors are at risk for permanent health sequelae. Although event-free survival appropriately represents the outcome for cancers with poor overall survival, this metric is inadequate when cure rates are high but challenged by serious, persistent complications. Accordingly, a group of experts in paediatric haematology-oncology, representative of 17 international acute lymphocytic leukaemia study groups, launched an initiative to construct a measure, designated severe toxicity-free survival (STFS), to quantify the occurrence of physician-prioritised toxicities to be integrated with standard cancer outcome reporting. Five generic inclusion criteria (not present before cancer diagnosis, symptomatic, objectifiable, of unacceptable severity, permanent, or requiring unacceptable treatments) were used to assess 855 health conditions, which resulted in inclusion of 21 severe toxicities. Consensus definitions were reached through a modified Delphi process supplemented by two additional plenary meetings. The 21 severe toxicities include severe adverse health conditions that substantially affect activities of daily living and are refractory to therapy (eg, refractory seizures), are without therapeutic options (eg, blindness), or require substantially invasive treatment (eg, cardiac transplantation). Incorporation of STFS assessment into clinical trials has the potential to improve and diversify treatment strategies, focusing not only on traditional outcome events and overall survival but also the frequencies of the most severe toxicities. The two major aims of this Review were to: prioritise and define unacceptable long-term toxicity for patients with childhood acute lymphocytic leukaemia, and define how these toxicities should be combined into a composite quantity to be integrated with other reported outcomes. Although STFS quantifies the clinically unacceptable health tradeoff for cure using childhood acute lymphocytic leukaemia as a model disease, the prioritised severe toxicities are based on generic considerations of relevance to any other cancer diagnosis and age group.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Hematologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Hematology (hsv//eng)

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