Consensus definitions of 14 severe acute toxic effects for childhood lymphoblastic leukaemia treatment: a Delphi consensus

. 2016 Jun ; 17 (6) : e231-e239.

Jazyk angličtina Země Velká Británie, Anglie Médium print

Typ dokumentu časopisecké články, přehledy

Perzistentní odkaz   https://www.medvik.cz/link/pmid27299279
Odkazy

PubMed 27299279
DOI 10.1016/s1470-2045(16)30035-3
PII: S1470-2045(16)30035-3
Knihovny.cz E-zdroje

Although there are high survival rates for children with acute lymphoblastic leukaemia, their outcome is often counterbalanced by the burden of toxic effects. This is because reported frequencies vary widely across studies, partly because of diverse definitions of toxic effects. Using the Delphi method, 15 international childhood acute lymphoblastic leukaemia study groups assessed acute lymphoblastic leukaemia protocols to address toxic effects that were to be considered by the Ponte di Legno working group. 14 acute toxic effects (hypersensitivity to asparaginase, hyperlipidaemia, osteonecrosis, asparaginase-associated pancreatitis, arterial hypertension, posterior reversible encephalopathy syndrome, seizures, depressed level of consciousness, methotrexate-related stroke-like syndrome, peripheral neuropathy, high-dose methotrexate-related nephrotoxicity, sinusoidal obstructive syndrome, thromboembolism, and Pneumocystis jirovecii pneumonia) that are serious but too rare to be addressed comprehensively within any single group, or are deemed to need consensus definitions for reliable incidence comparisons, were selected for assessment. Our results showed that none of the protocols addressed all 14 toxic effects, that no two protocols shared identical definitions of all toxic effects, and that no toxic effect definition was shared by all protocols. Using the Delphi method over three face-to-face plenary meetings, consensus definitions were obtained for all 14 toxic effects. In the overall assessment of outcome of acute lymphoblastic leukaemia treatment, these expert opinion-based definitions will allow reliable comparisons of frequencies and severities of acute toxic effects across treatment protocols, and facilitate international research on cause, guidelines for treatment adaptation, preventive strategies, and development of consensus algorithms for reporting on acute lymphoblastic leukaemia treatment.

Children's Cancer Center National Center for Child Health and Development Tokyo Japan

Christian Albrechts University Kiel and University Medical Center Schleswig Holstein Department of Pediatrics Kiel Germany

Clinic of Pediatric Hematology Oncology Department of Women's and Children's Health Padova Italy

Dana Farber Cancer Institute and Boston Children's Hospital Boston MA USA

Department of Paediatric and Adolescent Haematology Oncology and Children's Haemopoietic Stem Cell Transplant Unit Great North Children's Hospital Newcastle upon Tyne UK

Department of Pediatric Hematology and Oncology St Anna Children's Hospital Vienna Austria; Department of Pediatric and Adolescent Medicine Medical University of Vienna Vienna Austria

Department of Pediatrics Aalborg University Hospital Aalborg Denmark

Department of Pediatrics Aarhus University Hospital Aarhus N Denmark

Department of Pediatrics and Adolescent Medicine Rigshospitalet Copenhagen Denmark

Department of Pediatrics and Adolescent Medicine Rigshospitalet Copenhagen Denmark; Institute of Clinical Medicine Faculty of Medicine University of Copenhagen Copenhagen Denmark; Department of Pediatric Oncology Langone Medical Center New York University New York NY USA

Department of Pediatrics Oulu University Hospital Oulu Finland

Division of Pediatric Hematology Oncology Mackay Memorial Hospital Taipei Taiwan

Dutch Childhood Oncology Group The Hague Netherlands; Erasmus Medical Center Sophia Children's Hospital Department of Pediatric Hematology Oncology Rotterdam Netherlands

EORTC Children's Leukemia Group and University Department of Pediatric Oncology CHR Citadelle Liège Belgium

Institute of Cancer Sciences College of Medical Veterinary and Life Sciences University of Glasgow Glasgow UK

Schneider Children's Medical Center of Israel Department of Pediatric Hematology Oncology Petah Tikva Israel

St Jude Children's Research Hospital Memphis TN USA

University College London's NHS Foundation Trust London UK

University Hospital Motol Department of Pediatric Hematology Oncology Prague Czech Republic

University Medical Center Eppendorf Clinic of Pediatric Hematology and Oncology Hamburg Germany

University of Utah Department of Pediatrics and Huntsman Cancer Institute Salt Lake City UT USA

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