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

Andrés‐Jensen, Liv; Attarbaschi, Andishe; Bárdi, Edit; Barzilai‐Birenboim, Shlomit; Bhojwani, Deepa; Halsey, Christina; Harila‐Saari, Arja; Hudson, Melissa M.; Jeha, Sima; Kato, Motohiro; Kremer, Leontien C. M.; Młynarski, Wojciech; Möricke, Anja; Pieters, Rob; Piette, Caroline; Raetz, Elizabeth A.; Ronceray, Leila; Toro, Claudia; Valsecchi, Maria Grazia; Vrooman, Lynda M.; Weinreb, Sigal; Winick, Naomi J.; Schmiegelow, Kjeld; Adams, Madeline; Baust, Katja; Boesten, Tineke; Calaminus, Gabriele; Conyers, Rachel; Darlington, Anne‐Sophie; Ville, Maëlle de; Escherich, Gabriele; Hagleitner, Melanie M.; Hou, Jen‐Yin; Huang, Ting‐Huan; Jenney, Meriel; Krawczuk‐Rybak, Maryna; Kremer, L.; Lautem, Melchior; Liu, Hse-Che; López, Elixabet López; Mateos, Marion K.; Muszyńska-Rosłan, Katarzyna; Niinimäki, Riitta; Trahair, Toby N.; Sluis, Inge van der; Litsenburg, Raphaële R. L. van; Wiener, Andreas; Yano, Michihiro; Yeh, Ting‐Chi; Zápotocká, Ester

doi:10.1016/s2352-3026(21)00136-8

Cited by 17 publications

(17 citation statements)

References 74 publications

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“…In this study, the incidence of epileptic seizures was 5.2% in ALL children. The related studies reported that the incidence of epileptic seizures in ALL children receiving different regimens was 8 ~ 13% ( 12 – 14 ). The incidence of this study was relatively low.…”

Section: Discussionmentioning

confidence: 99%

Clinical Analysis of Childhood Acute Lymphoblastic Leukemia With Epilepsy Seizures

Tang

Zhang

et al. 2022

Front. Neurol.

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ObjectiveIn order to analyze the clinical characteristics of epileptic seizures in children with acute lymphoblastic leukemia (ALL) during treatment.MethodsThe clinical and imaging data of children diagnosed as ALL with epilepsy seizures from January 2013 to December 2020 were retrospectively analyzed.ResultsA total of 2217 children with ALL were admitted during the study, of whom 229 (10.33%) had epileptic seizures after ALL treatment. Among them, 45 (19.65%) were in the high-risk group and 184 (80.35%) were in the low-risk group. Epileptic seizures mainly occurred in the induction remission period (24.02%), maintenance treatment period (25.33%) and after bone marrow transplantation (21.40%). The common causes were MTX-related demyelinating encephalopathy (34.06%) and reversible posterior encephalopathy syndrome (PRES) (25.3%). The first symptom was mainly convulsion (34.50%). The first attack had a comprehensive attack and partial attack. Most patients stop themselves. 30 cases (13.10%) had acute recurrence of epilepsy (recurrence within 3 months after the first attack), and 49 cases (25.76%) had neurological dysfunction after follow-up. 36 cases developed symptomatic epilepsy. Among the 130 children who completed the follow-up, 78 (60.00%) had no obvious neurological sequelae, and 52 (40.0%) had neurological sequelae. Among the 52 cases, there were 34 cases of mild sequelae and 18 cases of severe sequelae, including 8 cases of epilepsy combined with cognitive impairment.ConclusionEpileptic seizure is a common neurological complication during ALL treatment. The etiology and associated manifestations of the first epileptic seizure are diverse. Early neuroimaging and EEG examination are helpful for early diagnosis and treatment.

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Section: Discussionmentioning

confidence: 99%

Clinical Analysis of Childhood Acute Lymphoblastic Leukemia With Epilepsy Seizures

Tang

Zhang

et al. 2022

Front. Neurol.

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“…However, future strategies should aim at identifying ALL patients at risk rigorously, such as children with cancer predisposition syndromes and immunodeficiencies, in order to adapt chemotherapy (i.e., alkylating agents, anthracyclines), if justified by growing evidence to have an effect and without losing anti‐leukemic efficacy. Furthermore, consortia should aim to establish standardized surveillance programs to detect SMNs as early as possible, especially in these at‐risk populations [ 3 ]. This may help increasing OS rates, as SMNs still are a prominent non‐relapse cause of death among pediatric ALL survivors.…”

Section: Resultsmentioning

confidence: 99%

“…Acute lymphoblastic leukemia (ALL) is the most common malignancy in childhood and adolescence [ 1 ]. With 5‐year overall survival (OS) rates reaching 90%, the number of long‐term survivors has risen, and it becomes increasingly important to not only focus on leukemia‐free survival, but also on the quality of survival by evaluating the long‐term toxicity of pediatric ALL treatment [ 1 , 2 , 3 ]. Long‐term ALL survivors may suffer from chronic health conditions, ranging from organ dysfunctions to the development of secondary malignant neoplasms (SMN) [ 3 , 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…With 5‐year overall survival (OS) rates reaching 90%, the number of long‐term survivors has risen, and it becomes increasingly important to not only focus on leukemia‐free survival, but also on the quality of survival by evaluating the long‐term toxicity of pediatric ALL treatment [ 1 , 2 , 3 ]. Long‐term ALL survivors may suffer from chronic health conditions, ranging from organ dysfunctions to the development of secondary malignant neoplasms (SMN) [ 3 , 4 , 5 ]. SMNs cause considerable morbidity and, after relapse, are the main causes of death for ALL patients, making it imperative to reduce risk factors for their development without compromising ALL treatment efficacy [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

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Second malignant neoplasms after treatment of 1487 children and adolescents with acute lymphoblastic leukemia—A population‐based analysis of the Austrian ALL‐BFM Study Group

Poyer

Dieckmann

Dworzak

et al. 2022

eJHaem

Self Cite

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Second malignant neoplasms (SMN) after primary childhood acute lymphoblastic leukemia (ALL) are rare. Among 1487 ALL patients diagnosed between 1981 and 2010 in Austria, the 10-year cumulative incidence of an SMN was 1.1% ± 0.3%. There was no difference in the 10-year incidence of SMNs with regard to diagnostic-, responseand therapy-related ALL characteristics except for a significantly higher incidence in patients with leukocytes ≥50.0 G/L at ALL diagnosis (2.1% ± 1.0% vs. 0% for 20.0-50.0 G/L, and 1.0% ± 0.3% for < 20.0 G/L; p = 0.033). Notably, there was no significant difference in the incidence of SMNs between patients with or without cranial radiotherapy (1.2% ± 0.5% vs. 0.8% ± 0.3%; p = 0.295). Future strategies must decrease the incidence of SMNs, as this event still leads to death in one-third (7/19) of the patients.

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“…Noninvasive imaging has assisted in the evaluation of children with a known or suspected disease. With the longer survival of these patients, it is clear that many patients suffer severe long term side effects from the treatments [1,2]. The treatment aim in paediatric oncology is to achieve a cure with the minimum long-term side effects.…”

Section: Introductionmentioning

confidence: 99%

The Impact of PET/CT on Paediatric Oncology

Brink

Hlongwa

2023

Diagnostics

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This review paper will discuss the use of positron emission tomography/computed tomography (PET/CT) in paediatric oncology. Functional imaging with PET/CT has proven useful to guide treatment by accurately staging disease and limiting unnecessary treatments by determining the metabolic response to treatment. 18F-Fluorodeoxyglucose (2-[18F]FDG) PET/CT is routinely used in patients with lymphoma. We highlight specific considerations in the paediatric population with lymphoma. The strengths and weaknesses for PET/CT tracers that compliment Meta-[123I]iodobenzylguanidine ([123I]mIBG) for the imaging of neuroblastoma are summarized. 2‑[18F]FDG PET/CT has increasingly been used in the staging and evaluation of disease response in sarcomas. The current recommendations for the use of PET/CT in sarcomas are given and potential future developments and highlighted. 2-[18F]FDG PET/CT in combination with conventional imaging is currently the standard for disease evaluation in children with Langerhans-cell Histiocytosis (LCH) and the non-LCH disease spectrum. The common pitfalls of 2-[18F]FDG PET/CT in this setting are discussed.

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

Cited by 17 publications

References 74 publications

Clinical Analysis of Childhood Acute Lymphoblastic Leukemia With Epilepsy Seizures

Clinical Analysis of Childhood Acute Lymphoblastic Leukemia With Epilepsy Seizures

Second malignant neoplasms after treatment of 1487 children and adolescents with acute lymphoblastic leukemia—A population‐based analysis of the Austrian ALL‐BFM Study Group

The Impact of PET/CT on Paediatric Oncology

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