Consensus definitions of 14 severe acute toxic effects for childhood lymphoblastic leukaemia treatment: a Delphi consensus
Language English Country England, Great Britain Media print
Document type Journal Article, Review
PubMed
27299279
DOI
10.1016/s1470-2045(16)30035-3
PII: S1470-2045(16)30035-3
Knihovny.cz E-resources
- MeSH
- Precursor Cell Lymphoblastic Leukemia-Lymphoma therapy MeSH
- Delphi Technique MeSH
- Child MeSH
- Combined Modality Therapy adverse effects MeSH
- Consensus MeSH
- Humans MeSH
- Drug-Related Side Effects and Adverse Reactions etiology prevention & control MeSH
- Toxicity Tests, Acute MeSH
- Radiation Tolerance * MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
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
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 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 Oulu University Hospital Oulu Finland
Division of Pediatric Hematology Oncology Mackay Memorial Hospital Taipei Taiwan
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
References provided by Crossref.org
The EHA Research Roadmap: Malignant Lymphoid Diseases
Recent advances in the management of pediatric acute lymphoblastic leukemia
