A retrospective analysis of complications observed in children with acute lymphoblastic leukemia during chemotherapy

Abstract

BACKGROUND: We aimed to evaluate the complications that we observed in children with acute lymphoblastic leukemia (ALL) during the remission induction, consolidation, and reinduction phases of chemotherapy retrospectively. METHODS: We analysed the clinical records of 128 patients with ALL who were diagnosed and treated in the Department of Pediatric Hematology of Istanbul Medeniyet University Gortepe Training Hospital between August 2009 and April 2014 to document the acute complication other than febrile neutropenia episodes, which developed during the induction, consolidation and reinduction phases of chemotherapy. RESULTS: We documented 279 complications. Of these, 53.05% were in males, 46.95% in females; 32.26% were in standard-risk, 45.52% in medium-risk, 22.22% in high-risk group of patients. Common documented events were pneumonia (25%), therapy-induced hyperglycemia (16.40%) therapy-related hepatitis (15.6%), generalized tonic-clonic seizures (14.8%), anaphylaxis to asparaginase (14.1%), hypertension (13.3%) varicella zoster virus (VZV) infection (13.3%), renal tubulopathy (12.5%). Time of complications was induction phase in 32.62%, consolidation in 19.35%, HR blocks in 18.28%, reinduction 29.75% during the phases. Mortality rate due to complications was 13.28%. CONCLUSIONS: Therapy-related complications can limit the survival rates in children with ALL. To minimize the treatment burden, even very rare complications must be considered and treated promptly with a multidisciplinary approach.