{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T01:57:47Z","timestamp":1790647067647,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,8,2]],"date-time":"2017-08-02T00:00:00Z","timestamp":1501632000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004963","name":"Seventh Framework Programme","doi-asserted-by":"publisher","award":["278514"],"award-info":[{"award-number":["278514"]}],"id":[{"id":"10.13039\/501100004963","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007311","name":"Deutsche Kinderkrebsstiftung","doi-asserted-by":"publisher","award":["DKS 2012.12"],"award-info":[{"award-number":["DKS 2012.12"]}],"id":[{"id":"10.13039\/501100007311","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>The prognosis in children with refractory or relapsed (r\/r) T\u2010cell acute lymphoblastic leukaemia (T\u2010ALL) or lymphoblastic lymphoma (T\u2010LBL) is poor. Nelarabine (Ara\u2010G) has successfully been used as salvage therapy in these children, but has been associated with significant, even fatal, neurotoxicities. We retrospectively analysed 52 patients with r\/r T\u2010ALL\/T\u2010LBL aged \u226419\u00a0years who were treated with Ara\u2010G alone (<jats:italic>n<\/jats:italic>\u00a0=\u00a025) or in combination with cyclophosphamide and etoposide (<jats:italic>n<\/jats:italic>\u00a0=\u00a027). The majority of patients (45\/52) received 1\u20132 cycles of Ara\u2010G. Seventeen patients (32\u00b77%) had refractory disease, 28 (53\u00b78%) were in first relapse and 7 (13\u00b75%) were in second relapse. A response to Ara\u2010G was achieved in 20 patients and 15 (28\u00b78%) were in remission at last follow\u2010up. Twelve patients (23\u00b71%) had neurotoxic adverse effects (neuro\u2010AE) of any grade, of whom 7 (13\u00b75%) developed neurotoxicity \u2265 grade III. The most frequent neuro\u2010AEs were peripheral motor neuropathy (19\u00b72%), peripheral sensory neuropathy (11\u00b75%) and seizures (9\u00b76%). Three patients died of central neuro\u2010AE after 1\u20132 cycles of combination therapy. Patients with neurotoxicity were significantly older (median 15\u00b717\u00a0years) than those without (10\u00b734\u00a0years, <jats:italic>P<\/jats:italic>\u00a0=\u00a00\u00b7017). No differences were observed between mono\u2010 and combination therapy concerning outcome and neuro\u2010AE. The incidence of neuro\u2010AE was not associated with concurrent intrathecal therapy or prior central nervous system irradiation.<\/jats:p>","DOI":"10.1111\/bjh.14877","type":"journal-article","created":{"date-parts":[[2017,8,3]],"date-time":"2017-08-03T19:29:42Z","timestamp":1501788582000},"page":"272-283","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Neurotoxic side effects in children with refractory or relapsed T\u2010cell malignancies treated with nelarabine based therapy"],"prefix":"10.1111","volume":"179","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4577-0503","authenticated-orcid":false,"given":"Michaela","family":"Kuhlen","sequence":"first","affiliation":[{"name":"Department of Paediatric Oncology, Haematology and Clinical Immunology University Children's Hospital, Medical Faculty, Heinrich Heine University Duesseldorf Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsten","family":"Bleckmann","sequence":"additional","affiliation":[{"name":"Department of Paediatrics University Hospital Schleswig\u2010Holstein Kiel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anja","family":"M\u00f6ricke","sequence":"additional","affiliation":[{"name":"Department of Paediatrics University Hospital Schleswig\u2010Holstein Kiel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Schrappe","sequence":"additional","affiliation":[{"name":"Department of Paediatrics University Hospital Schleswig\u2010Holstein Kiel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Vieth","sequence":"additional","affiliation":[{"name":"Department of Paediatrics University Hospital Schleswig\u2010Holstein Kiel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Escherich","sequence":"additional","affiliation":[{"name":"Clinic of Paediatric Haematology and Oncology Medical Centre Hamburg\u2010Eppendorf Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annika","family":"Bronsema","sequence":"additional","affiliation":[{"name":"Clinic of Paediatric Haematology and Oncology Medical Centre Hamburg\u2010Eppendorf Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annika","family":"Vonalt","sequence":"additional","affiliation":[{"name":"Department of General Paediatrics, Oncology\/Haematology University Children's Hospital Tuebingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manon","family":"Queudeville","sequence":"additional","affiliation":[{"name":"Department of General Paediatrics, Oncology\/Haematology University Children's Hospital Tuebingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. Michel","family":"Zwaan","sequence":"additional","affiliation":[{"name":"Department of Paediatric Oncology\/Haematology Erasmus MC\u2010Sophia Children's Hospital Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4229-8058","authenticated-orcid":false,"given":"Martin","family":"Ebinger","sequence":"additional","affiliation":[{"name":"Department of General Paediatrics, Oncology\/Haematology University Children's Hospital Tuebingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus\u2010Michael","family":"Debatin","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescent Medicine University Medical Centre Ulm Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Klingebiel","sequence":"additional","affiliation":[{"name":"Department of Paediatrics University Hospital Frankfurt Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ewa","family":"Koscielniak","sequence":"additional","affiliation":[{"name":"Department of Paediatric Oncology, Haematology and Immunology Klinikum Stuttgart Olgahospital Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Rossig","sequence":"additional","affiliation":[{"name":"Paediatric Haematology and Oncology University Children\u2032s Hospital Muenster Muenster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1151-829X","authenticated-orcid":false,"given":"Birgit","family":"Burkhardt","sequence":"additional","affiliation":[{"name":"Paediatric Haematology and Oncology University Children\u2032s Hospital Muenster Muenster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reinhard","family":"Kolb","sequence":"additional","affiliation":[{"name":"Department of General Paediatrics, 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