Risk factors for treatment related mortality in childhood acute lymphoblastic leukaemia
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Jonsson, O G
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CitationPediatr Blood Cancer. 2011, 56(4):551-559
AbstractBACKGROUND: In spite of major improvements in the cure rate of childhood acute lymphoblastic leukaemia (ALL), 2-4% of patients still die from treatment related complications. PROCEDURE: We investigated the pattern of treatment related deaths (TRDs) and possible risk factors in the NOPHO ALL-92 and ALL-2000 protocols. Fifty-five TRDs were identified among the 1,645 ALL-92 patients and 33 among the 1,090 ALL-2000 patients. RESULTS: There was no significant difference in the incidence of TRDs between the two protocols (3.4% vs. 3.2%). Five patients died before initiation of therapy (0.2%), and the overall subsequent risk of induction death and death in first complete remission (CR1) was 1.2% and 1.8%, respectively. Infections were the major cause of death comprising 72% of all cases including 9 deaths from Pseudomonas aeruginosa and 11 deaths from fungal infections. Other causes of death included bleeding or thrombosis (eight patients), tumour burden related toxicities (seven patients) and organ toxicity (seven patients). Female gender (hazard ratio (HR): 2.2, 95% confidence interval (95% CI): 1.4-3.4), high white blood cell count (≥200 × 10(9) /L) at diagnosis (HR: 3.5, 95% CI: 1.7-7.1), T-cell disease (HR: 1.9, 95% CI: 1.01-3.7), Down syndrome (HR: 7.3, 95% CI: 3.6-14.9) and haematopoietic stem cell transplantation in CR1 (HR: 8.0, 95% CI: 3.3-19.5) were identified as independent risk factors for TRD. CONCLUSION: Several TRDs were potentially preventable and future efforts should be directed towards patients at risk.
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- Treatment-related death in childhood acute lymphoblastic leukaemia in the Nordic countries: 1992-2001.
- Authors: Christensen MS, Heyman M, Möttönen M, Zeller B, Jonmundsson G, Hasle H, Nordic Society of Paediatric Haematology and Oncology (NOPHO).
- Issue date: 2005 Oct
- [Treatment strategy for childhood and adolescent acute lymphoblastic leukemia in first remission].
- Authors: Hori H
- Issue date: 2010 Jul
- Minimal residual disease-based augmented therapy in childhood acute lymphoblastic leukemia: a report from the Japanese Childhood Cancer and Leukemia Study Group.
- Authors: Yamaji K, Okamoto T, Yokota S, Watanabe A, Horikoshi Y, Asami K, Kikuta A, Hyakuna N, Saikawa Y, Ueyama J, Watanabe T, Okada M, Taga T, Kanegane H, Kogawa K, Chin M, Iwai A, Matsushita T, Shimomura Y, Hori T, Tsurusawa M, Japanese Childhood Cancer Leukemia Study Group.
- Issue date: 2010 Dec 15
- Dexamethasone in the maintenance phase of acute lymphoblastic leukaemia treatment: is the risk of lethal infections too high?
- Authors: Te Poele EM, de Bont ES, Marike Boezen H, Revesz T, Bökkerink JP, Beishuizen A, Nijhuis IJ, Oude Nijhuis CS, Veerman AJ, Kamps WA
- Issue date: 2007 Nov
- [Allogenic bone marrow transplantation versus autograft in acute lymphoblastic leukemia, in second remission in 113 children. Results of the Grupo Español de Transplante de Medula Niños (GETMON)].
- Authors: Badell I, Ortega JJ, Muñoz A, Bureo E, Madero L, Olivé T, Cubells J, Maldonado MS, Baro J, Díaz MA
- Issue date: 1996 Apr