Table 5.

Selected major toxic effects of treatment according to risk or age group at diagnosis

Toxic effectNo. of patients3-y cumulative risk, % (95% CI)P
Severe adverse events (grade 4 or 5)    
 All patients 831 11.3 (10.6-12.0)  
 Intermediate-risk or high-risk group 545 15.4 (14.2-16.5) <.001 
 Low-risk group 286 7.6 (6.7-8.5)  
 Age <10 y 630 9.9 (9.2-10.6) <.001 
 Age ≥10 y 201 20.6 (18.0-23.2)  
Sepsis (grade 3, 4, or 5)    
 All patients 1189 15.9 (15.1-16.7)  
 Intermediate-risk or high-risk group 768 21.3 (20.0-22.6) <.001 
 Low-risk group 421 10.9 (9.9-11.9)  
 Age <10 y 984 15.2 (14.3-16.1) <.001 
 Age ≥10 y 205 20.4 (17.9-22.9)  
Severe pneumonia (grade 3, 4, or 5)    
 All patients 345 4.9 (4.4-5.4)  
 Intermediate-risk or high-risk group 193 5.7 (4.9-6.5) .003 
 Low-risk group 152 4.1 (3.5-4.7)  
 Age <10 y 295 4.8 (4.3-5.3) .50 
 Age ≥10 y 50 5.6 (4.1-7.1)  
Invasive fungal infection (grade 3, 4, or 5)    
 All patients 340 4.6 (4.1-5.1)  
 Intermediate-risk or high-risk group 209 6.0 (5.5-6.5) <.001 
 Low-risk group 131 3.4 (2.8-4.2)  
 Age <10 y 275 4.3 (3.8-4.8) .001 
 Age ≥10 y 65 6.8 (5.2-8.4)  
Allergic reaction to asparaginase (grade 2, 3, or 4)    
 All patients 315 4.2 (3.7-4.7)  
 Intermediate-risk or high-risk group 151 4.1 (3.5-4.7) .95 
 Low-risk group 164 4.2 (3.6-4.8)  
 Age <10 y 287 4.4 (3.9-4.9) .02 
 Age ≥10 y 28 2.8 (1.8-3.8)  
Pancreatitis (grade 3, 4, or 5)    
 All patients 296 3.9 (3.5-4.3)  
 Intermediate-risk or high-risk group 211 5.8 (5.0-6.6) <.001 
 Low-risk group 85 2.2 (1.7-2.7)  
 Age <10 y 211 3.2 (2.8-3.6) <.001 
 Age ≥10 y 85 8.4 (6.7-10.1)  
Thrombosis (grade 3 or 4)    
 All patients 157 2.1 (1.8-2.4)  
 Intermediate-risk or high-risk group 79 2.2 (1.7-2.7) .62 
 Low-risk group 78 2.0 (1.6-2.4)  
 Age <10 y 128 1.9 (1.6-2.2) .06 
 Age ≥10 y 29 2.9 (1.9-3.9)  
Tumor lysis syndrome (grade 3 or 4)    
 All patients 141 1.8 (1.5-2.1)  
 Intermediate-risk or high-risk group 122 3.3 (2.7-3.9) <.001 
 Low-risk group 19 0.5 (0.3-0.7)  
 Age <10 y 96 1.5 (1.2-1.8) <.001 
 Age ≥10 y 45 4.4 (3.1-5.7)  
Seizure (grade 2, 3, or 4)    
 All patients 86 1.2 (1.0-1.4)  
 Intermediate-risk or high-risk group 57 1.6 (1.2-2.0) <.001 
 Low-risk group 29 0.8 (0.5-1.1)  
 Age <10 y 64 1.0 (0.8-1.2) <.001 
 Age ≥10 y 22 2.2 (1.3-3.1)  
Osteonecrosis (grade 3 or 4)    
 All patients 23 0.4 (0.2-0.6)  
 Intermediate-risk or high-risk group 18 0.6 (0.3-0.9) <.001 
 Low-risk group 0.2 (0-0.4)  
 Age <10 y 0.1 (0-0.2) <.001 
 Age ≥10 y 17 2.3 (1.2-3.4)  
Toxic effectNo. of patients3-y cumulative risk, % (95% CI)P
Severe adverse events (grade 4 or 5)    
 All patients 831 11.3 (10.6-12.0)  
 Intermediate-risk or high-risk group 545 15.4 (14.2-16.5) <.001 
 Low-risk group 286 7.6 (6.7-8.5)  
 Age <10 y 630 9.9 (9.2-10.6) <.001 
 Age ≥10 y 201 20.6 (18.0-23.2)  
Sepsis (grade 3, 4, or 5)    
 All patients 1189 15.9 (15.1-16.7)  
 Intermediate-risk or high-risk group 768 21.3 (20.0-22.6) <.001 
 Low-risk group 421 10.9 (9.9-11.9)  
 Age <10 y 984 15.2 (14.3-16.1) <.001 
 Age ≥10 y 205 20.4 (17.9-22.9)  
Severe pneumonia (grade 3, 4, or 5)    
 All patients 345 4.9 (4.4-5.4)  
 Intermediate-risk or high-risk group 193 5.7 (4.9-6.5) .003 
 Low-risk group 152 4.1 (3.5-4.7)  
 Age <10 y 295 4.8 (4.3-5.3) .50 
 Age ≥10 y 50 5.6 (4.1-7.1)  
Invasive fungal infection (grade 3, 4, or 5)    
 All patients 340 4.6 (4.1-5.1)  
 Intermediate-risk or high-risk group 209 6.0 (5.5-6.5) <.001 
 Low-risk group 131 3.4 (2.8-4.2)  
 Age <10 y 275 4.3 (3.8-4.8) .001 
 Age ≥10 y 65 6.8 (5.2-8.4)  
Allergic reaction to asparaginase (grade 2, 3, or 4)    
 All patients 315 4.2 (3.7-4.7)  
 Intermediate-risk or high-risk group 151 4.1 (3.5-4.7) .95 
 Low-risk group 164 4.2 (3.6-4.8)  
 Age <10 y 287 4.4 (3.9-4.9) .02 
 Age ≥10 y 28 2.8 (1.8-3.8)  
Pancreatitis (grade 3, 4, or 5)    
 All patients 296 3.9 (3.5-4.3)  
 Intermediate-risk or high-risk group 211 5.8 (5.0-6.6) <.001 
 Low-risk group 85 2.2 (1.7-2.7)  
 Age <10 y 211 3.2 (2.8-3.6) <.001 
 Age ≥10 y 85 8.4 (6.7-10.1)  
Thrombosis (grade 3 or 4)    
 All patients 157 2.1 (1.8-2.4)  
 Intermediate-risk or high-risk group 79 2.2 (1.7-2.7) .62 
 Low-risk group 78 2.0 (1.6-2.4)  
 Age <10 y 128 1.9 (1.6-2.2) .06 
 Age ≥10 y 29 2.9 (1.9-3.9)  
Tumor lysis syndrome (grade 3 or 4)    
 All patients 141 1.8 (1.5-2.1)  
 Intermediate-risk or high-risk group 122 3.3 (2.7-3.9) <.001 
 Low-risk group 19 0.5 (0.3-0.7)  
 Age <10 y 96 1.5 (1.2-1.8) <.001 
 Age ≥10 y 45 4.4 (3.1-5.7)  
Seizure (grade 2, 3, or 4)    
 All patients 86 1.2 (1.0-1.4)  
 Intermediate-risk or high-risk group 57 1.6 (1.2-2.0) <.001 
 Low-risk group 29 0.8 (0.5-1.1)  
 Age <10 y 64 1.0 (0.8-1.2) <.001 
 Age ≥10 y 22 2.2 (1.3-3.1)  
Osteonecrosis (grade 3 or 4)    
 All patients 23 0.4 (0.2-0.6)  
 Intermediate-risk or high-risk group 18 0.6 (0.3-0.9) <.001 
 Low-risk group 0.2 (0-0.4)  
 Age <10 y 0.1 (0-0.2) <.001 
 Age ≥10 y 17 2.3 (1.2-3.4)  
Close Modal

or Create an Account

Close Modal
Close Modal