Prevalence of 21 Physician-Defined Severe Toxicities Following Childhood Acute Lymphoblastic Leukemia Treatment: Australian Retrospective Cohort Study
Our study reveals that 22.6% of patients with ALL experienced severe toxicities according to the STFS endpoint.
This retrospective cohort study evaluated the prevalence of 21 physician‑defined severe toxicities using the severe toxicity‑free survival framework in pediatric acute lymphoblastic leukemia (ALL) survivors who had received treatment at the Royal Children’s Hospital, Melbourne, Australia, and had survived more than five years since diagnosis. Of the 345 eligible patients (median age 4 years, 46.7% female), 22.6% experienced at least one severe toxicity. Mental health concerns were the most common (9.6%), followed by osteonecrosis (6.7%) and a composite group of paralytic, neuropathic, myopathic and movement disorders (4.1%). The findings underscore the need for ongoing surveillance and intervention for this spectrum of toxicities in ALL survivors.
Severe toxicities after ALL treatment represent a significant clinical burden and may impair long‑term quality of life. Understanding their prevalence and patterns informs risk stratification, surveillance protocols and the development of adjunctive therapies to mitigate morbidity.
Evidence level: Állatkísérletes. Állatmodellben vizsgálták.
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