NON-INFECTIOUS ACUTE TOXICITIES IN PEDIATRIC PATIENTS WITH ACUTE LYMPHOBLASTIC LEUKEMIA RECEIVING INTENSIVE CHEMOTHERAPY: EVALUATION WITH STANDARDIZED CRITERIA
58th Congress of the International Society of Paediatric Oncology (SIOP), Texas, Amerika Birleşik Devletleri, 15 - 18 Eylül 2026, cilt.1, ss.236, (Özet Bildiri)
- Yayın Türü: Bildiri / Özet Bildiri
- Cilt numarası: 1
- Basıldığı Şehir: Texas
- Basıldığı Ülke: Amerika Birleşik Devletleri
- Sayfa Sayıları: ss.236
- Dokuz Eylül Üniversitesi Adresli: Evet
Özet
Background and Aims Treatment-related acute toxicities remain important causes of morbidity and treatment modification in acute lymphoblastic leukemia (ALL). This study aimed to evaluate the frequency, distribution, and clinical outcomes of non-infectious acute toxicities developing during intensive chemotherapy using internationally accepted standardized classification systems, and to determine independent risk factors associated with toxicity development. Methods A total of 134 patients with ALL, who were treated with BFM-based protocols were retrospectively analyzed. Non-infectious acute toxicities were graded in a standardized manner using both the NCI Common Terminology Criteria for Adverse Events (CTCAE) v5.0 and ALL-specific Ponte di Legno (PDL) consensus criteria. Thus, methodological standardization was ensured by applying both the general oncological toxicity classification system and disease-specific consensus definitions. Independent risk factors for high toxicity risk (≥2 different toxicities) were evaluated using multivariate logistic regression analysis. Results At least one non-infectious acute toxicity developed in 87.3% of the patients. The treatment-related mortality rate was 3%. Sixty-seven percent of observed toxicities occurred during the induction phase. The most common toxicities were mucositis (74.6%), hypertension (28.4%), and psychiatric disorders (15.7%). In multivariate analysis, older age at diagnosis was identified as an independent risk factor for increased toxicity risk (p=0.005), whereas being in the standard-risk group was found to be protective (p=0.048). The adolescent age group had a markedly higher risk for thrombosis, metabolic complications, and psychiatric disorders. While body mass index was not associated with overall toxicity burden, it was a significant risk factor for the development of diabetes and hyperlipidemia. The rates of pancreatitis (2.2%), osteonecrosis (0.7%), and sinusoidal obstruction syndrome (2.2%) defined according to PDL criteria were consistent with the literature. Conclusions The burden of non-infectious acute toxicity is high among adolescents and high-risk groups. Early identification of risk factors and follow-up strategies based on standardized toxicity classification are critical for planning personalized supportive treatments and reducing morbidity