Toxicity profile and treatment delays in NOPHO ALL2008-comparing adults and children with Philadelphia chromosome-negative acute lymphoblastic leukemia

Nina Toft; Henrik Birgens; Jonas Abrahamsson; Laimonas Griškevičius; Helene Hallböök; Mats Heyman; Tobias Wirenfeldt Klausen; Ólafur Gísli Jónsson; Katrin Palk; Kaie Pruunsild; Petter Quist-Paulsen; Goda Vaitkeviciene; Kim Vettenranta; Ann Asberg; Louise Rold Helt; Thomas Frandsen; K. Schmiegelow

doi:10.1111/ejh.12562

Toxicity profile and treatment delays in NOPHO ALL2008-comparing adults and children with Philadelphia chromosome-negative acute lymphoblastic leukemia

Nina Toft, Henrik Birgens, Jonas Abrahamsson, Laimonas Griškevičius, Helene Hallböök, Mats Heyman, Tobias Wirenfeldt Klausen, Ólafur Gísli Jónsson, Katrin Palk, Kaie Pruunsild, Petter Quist-Paulsen, Goda Vaitkeviciene, Kim Vettenranta, Ann Asberg, Louise Rold Helt, Thomas Frandsen, K. Schmiegelow

Institut for Klinisk Medicin

33 Citationer (Scopus)

Abstract

Objectives: Cure rates improve when adolescents and young adults with acute lymphoblastic leukemia (ALL) are treated according to pediatric protocols. Assumed risks of toxicities and associated delays in treatment have played a role in setting upper age limits. The aim of this study was to examine the toxicity profile and treatment delays in NOPHO ALL2008 comparing children and adults. Methods: We collected information on 19 treatment-related toxicities, systematically captured at 3-month intervals throughout therapy, and time intervals between 12 consecutive treatment phases for 1076 patients aged 1-45 yrs treated according to the Nordic/Baltic ALL2008 protocol. Results: No adults died during induction. The duration of induction therapy and postinduction treatment phases did not differ between children and adults, except for patients 18-45 yrs being significantly delayed during two of nine high-risk blocks (median number of days for patients 1-9, 10-17, and 18-45 yrs; the glucocorticosteroid/antimetabolite-based block B1: 24, 26, and 29 d, respectively, P = 0.001, and Block 5 (in most cases also a B block): 29, 29, and 37 d, respectively, P = 0.02). A higher incidence of thrombosis with increasing age was found; highest odds ratio 5.4 (95% CI: (2.6;11.0)) for patients 15-17 yrs compared with children 1-9 yrs (P < 0.0001). Risk of avascular osteonecrosis was related to age with the highest OR for patients 10-14 yrs (OR = 10.4 (95% CI: (4.4;24.9)), P < 0.0001). Conclusion: Adults followed and tolerated the NOPHO ALL2008 protocol virtually as well as children, although thrombosis and avascular osteonecrosis was most common among adolescents.

Originalsprog	Engelsk
Tidsskrift	European Journal of Haematology
Vol/bind	96
Udgave nummer	2
Sider (fra-til)	160-169
Antal sider	10
ISSN	0902-4441
DOI	https://doi.org/10.1111/ejh.12562
Status	Udgivet - 1 feb. 2016

Adgang til dokumentet

10.1111/ejh.12562

Citationsformater

Toft, N., Birgens, H., Abrahamsson, J., Griškevičius, L., Hallböök, H., Heyman, M., Klausen, T. W., Jónsson, Ó. G., Palk, K., Pruunsild, K., Quist-Paulsen, P., Vaitkeviciene, G., Vettenranta, K., Asberg, A., Helt, L. R., Frandsen, T., & Schmiegelow, K. (2016). Toxicity profile and treatment delays in NOPHO ALL2008-comparing adults and children with Philadelphia chromosome-negative acute lymphoblastic leukemia. European Journal of Haematology, 96(2), 160-169. https://doi.org/10.1111/ejh.12562

Toxicity profile and treatment delays in NOPHO ALL2008-comparing adults and children with Philadelphia chromosome-negative acute lymphoblastic leukemia. / Toft, Nina; Birgens, Henrik; Abrahamsson, Jonas et al.

I: European Journal of Haematology, Bind 96, Nr. 2, 01.02.2016, s. 160-169.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Toft, N, Birgens, H, Abrahamsson, J, Griškevičius, L, Hallböök, H, Heyman, M, Klausen, TW, Jónsson, ÓG, Palk, K, Pruunsild, K, Quist-Paulsen, P, Vaitkeviciene, G, Vettenranta, K, Asberg, A, Helt, LR, Frandsen, T & Schmiegelow, K 2016, 'Toxicity profile and treatment delays in NOPHO ALL2008-comparing adults and children with Philadelphia chromosome-negative acute lymphoblastic leukemia', European Journal of Haematology, bind 96, nr. 2, s. 160-169. https://doi.org/10.1111/ejh.12562

@article{e55c99a2c4714cb592651b4e7321a665,

title = "Toxicity profile and treatment delays in NOPHO ALL2008-comparing adults and children with Philadelphia chromosome-negative acute lymphoblastic leukemia",

abstract = "Objectives: Cure rates improve when adolescents and young adults with acute lymphoblastic leukemia (ALL) are treated according to pediatric protocols. Assumed risks of toxicities and associated delays in treatment have played a role in setting upper age limits. The aim of this study was to examine the toxicity profile and treatment delays in NOPHO ALL2008 comparing children and adults. Methods: We collected information on 19 treatment-related toxicities, systematically captured at 3-month intervals throughout therapy, and time intervals between 12 consecutive treatment phases for 1076 patients aged 1-45 yrs treated according to the Nordic/Baltic ALL2008 protocol. Results: No adults died during induction. The duration of induction therapy and postinduction treatment phases did not differ between children and adults, except for patients 18-45 yrs being significantly delayed during two of nine high-risk blocks (median number of days for patients 1-9, 10-17, and 18-45 yrs; the glucocorticosteroid/antimetabolite-based block B1: 24, 26, and 29 d, respectively, P = 0.001, and Block 5 (in most cases also a B block): 29, 29, and 37 d, respectively, P = 0.02). A higher incidence of thrombosis with increasing age was found; highest odds ratio 5.4 (95% CI: (2.6;11.0)) for patients 15-17 yrs compared with children 1-9 yrs (P < 0.0001). Risk of avascular osteonecrosis was related to age with the highest OR for patients 10-14 yrs (OR = 10.4 (95% CI: (4.4;24.9)), P < 0.0001). Conclusion: Adults followed and tolerated the NOPHO ALL2008 protocol virtually as well as children, although thrombosis and avascular osteonecrosis was most common among adolescents.",

author = "Nina Toft and Henrik Birgens and Jonas Abrahamsson and Laimonas Gri{\v s}kevi{\v c}ius and Helene Hallb{\"o}{\"o}k and Mats Heyman and Klausen, {Tobias Wirenfeldt} and J{\'o}nsson, {{\'O}lafur G{\'i}sli} and Katrin Palk and Kaie Pruunsild and Petter Quist-Paulsen and Goda Vaitkeviciene and Kim Vettenranta and Ann Asberg and Helt, {Louise Rold} and Thomas Frandsen and K. Schmiegelow",

note = "{\textcopyright} 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.",

year = "2016",

month = feb,

day = "1",

doi = "10.1111/ejh.12562",

language = "English",

volume = "96",

pages = "160--169",

journal = "European Journal of Haematology",

issn = "0902-4441",

publisher = "Wiley-Blackwell",

number = "2",

}

TY - JOUR

T1 - Toxicity profile and treatment delays in NOPHO ALL2008-comparing adults and children with Philadelphia chromosome-negative acute lymphoblastic leukemia

AU - Toft, Nina

AU - Birgens, Henrik

AU - Abrahamsson, Jonas

AU - Griškevičius, Laimonas

AU - Hallböök, Helene

AU - Heyman, Mats

AU - Klausen, Tobias Wirenfeldt

AU - Jónsson, Ólafur Gísli

AU - Palk, Katrin

AU - Pruunsild, Kaie

AU - Quist-Paulsen, Petter

AU - Vaitkeviciene, Goda

AU - Vettenranta, Kim

AU - Asberg, Ann

AU - Helt, Louise Rold

AU - Frandsen, Thomas

AU - Schmiegelow, K.

PY - 2016/2/1

Y1 - 2016/2/1

N2 - Objectives: Cure rates improve when adolescents and young adults with acute lymphoblastic leukemia (ALL) are treated according to pediatric protocols. Assumed risks of toxicities and associated delays in treatment have played a role in setting upper age limits. The aim of this study was to examine the toxicity profile and treatment delays in NOPHO ALL2008 comparing children and adults. Methods: We collected information on 19 treatment-related toxicities, systematically captured at 3-month intervals throughout therapy, and time intervals between 12 consecutive treatment phases for 1076 patients aged 1-45 yrs treated according to the Nordic/Baltic ALL2008 protocol. Results: No adults died during induction. The duration of induction therapy and postinduction treatment phases did not differ between children and adults, except for patients 18-45 yrs being significantly delayed during two of nine high-risk blocks (median number of days for patients 1-9, 10-17, and 18-45 yrs; the glucocorticosteroid/antimetabolite-based block B1: 24, 26, and 29 d, respectively, P = 0.001, and Block 5 (in most cases also a B block): 29, 29, and 37 d, respectively, P = 0.02). A higher incidence of thrombosis with increasing age was found; highest odds ratio 5.4 (95% CI: (2.6;11.0)) for patients 15-17 yrs compared with children 1-9 yrs (P < 0.0001). Risk of avascular osteonecrosis was related to age with the highest OR for patients 10-14 yrs (OR = 10.4 (95% CI: (4.4;24.9)), P < 0.0001). Conclusion: Adults followed and tolerated the NOPHO ALL2008 protocol virtually as well as children, although thrombosis and avascular osteonecrosis was most common among adolescents.

AB - Objectives: Cure rates improve when adolescents and young adults with acute lymphoblastic leukemia (ALL) are treated according to pediatric protocols. Assumed risks of toxicities and associated delays in treatment have played a role in setting upper age limits. The aim of this study was to examine the toxicity profile and treatment delays in NOPHO ALL2008 comparing children and adults. Methods: We collected information on 19 treatment-related toxicities, systematically captured at 3-month intervals throughout therapy, and time intervals between 12 consecutive treatment phases for 1076 patients aged 1-45 yrs treated according to the Nordic/Baltic ALL2008 protocol. Results: No adults died during induction. The duration of induction therapy and postinduction treatment phases did not differ between children and adults, except for patients 18-45 yrs being significantly delayed during two of nine high-risk blocks (median number of days for patients 1-9, 10-17, and 18-45 yrs; the glucocorticosteroid/antimetabolite-based block B1: 24, 26, and 29 d, respectively, P = 0.001, and Block 5 (in most cases also a B block): 29, 29, and 37 d, respectively, P = 0.02). A higher incidence of thrombosis with increasing age was found; highest odds ratio 5.4 (95% CI: (2.6;11.0)) for patients 15-17 yrs compared with children 1-9 yrs (P < 0.0001). Risk of avascular osteonecrosis was related to age with the highest OR for patients 10-14 yrs (OR = 10.4 (95% CI: (4.4;24.9)), P < 0.0001). Conclusion: Adults followed and tolerated the NOPHO ALL2008 protocol virtually as well as children, although thrombosis and avascular osteonecrosis was most common among adolescents.

U2 - 10.1111/ejh.12562

DO - 10.1111/ejh.12562

M3 - Journal article

C2 - 25867866

SN - 0902-4441

VL - 96

SP - 160

EP - 169

JO - European Journal of Haematology

JF - European Journal of Haematology

IS - 2

ER -

Toxicity profile and treatment delays in NOPHO ALL2008-comparing adults and children with Philadelphia chromosome-negative acute lymphoblastic leukemia

Abstract

Adgang til dokumentet

Fingeraftryk

Citationsformater