{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T05:12:18Z","timestamp":1789017138710,"version":"build-2803163510"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2015,4,24]],"date-time":"2015-04-24T00:00:00Z","timestamp":1429833600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100008363","name":"Kr\u00e6ftens Bek\u00e6mpelse","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008363","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["European J of Haematology"],"published-print":{"date-parts":[[2016,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Cure rates improve when adolescents and young adults with acute lymphoblastic leukemia (<jats:styled-content style=\"fixed-case\">ALL<\/jats:styled-content>) 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 <jats:styled-content style=\"fixed-case\">NOPHO ALL<\/jats:styled-content>2008 comparing children and adults.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We collected information on 19 treatment\u2010related toxicities, systematically captured at 3\u2010month intervals throughout therapy, and time intervals between 12 consecutive treatment phases for 1076 patients aged 1\u201345\u00a0yrs treated according to the Nordic\/Baltic <jats:styled-content style=\"fixed-case\">ALL<\/jats:styled-content>2008 protocol.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>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\u201345\u00a0yrs being significantly delayed during two of nine high\u2010risk blocks (median number of days for patients 1\u20139, 10\u201317, and 18\u201345\u00a0yrs; the glucocorticosteroid\/antimetabolite\u2010based block B1: 24, 26, and 29\u00a0d, respectively, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.001, and Block 5 (in most cases also a B block): 29, 29, and 37\u00a0d, respectively, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.02). A higher incidence of thrombosis with increasing age was found; highest odds ratio 5.4 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: (2.6;11.0)) for patients 15\u201317\u00a0yrs compared with children 1\u20139\u00a0yrs (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.0001). Risk of avascular osteonecrosis was related to age with the highest <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> for patients 10\u201314\u00a0yrs (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a010.4 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: (4.4;24.9)), <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.0001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Adults followed and tolerated the <jats:styled-content style=\"fixed-case\">NOPHO ALL<\/jats:styled-content>2008 protocol virtually as well as children, although thrombosis and avascular osteonecrosis was most common among adolescents.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ejh.12562","type":"journal-article","created":{"date-parts":[[2015,4,13]],"date-time":"2015-04-13T13:54:22Z","timestamp":1428933262000},"page":"160-169","source":"Crossref","is-referenced-by-count":77,"title":["Toxicity profile and treatment delays in <scp>NOPHO ALL<\/scp>2008\u2014comparing adults and children with Philadelphia chromosome\u2010negative acute lymphoblastic leukemia"],"prefix":"10.1111","volume":"96","author":[{"given":"Nina","family":"Toft","sequence":"first","affiliation":[{"name":"Department of Hematology Herlev University Hospital University of Copenhagen Herlev Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrik","family":"Birgens","sequence":"additional","affiliation":[{"name":"Department of Hematology Herlev University Hospital University of Copenhagen Herlev Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas","family":"Abrahamsson","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Queen Silvia's Children's Hospital Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laimonas","family":"Gri\u0161kevi\u010dius","sequence":"additional","affiliation":[{"name":"Hematology, Oncology and Transfusion Medicine Center Vilnius University Hospital Santariskiu Klinikos Vilnius Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helene","family":"Hallb\u00f6\u00f6k","sequence":"additional","affiliation":[{"name":"Department of Hematology Uppsala University Hospital Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mats","family":"Heyman","sequence":"additional","affiliation":[{"name":"Childhood Cancer Research Unit Karolinska Institute Astrid Lindgren's Children's Hospital Karolinska University Hospital Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias Wirenfeldt","family":"Klausen","sequence":"additional","affiliation":[{"name":"Department of Hematology Herlev University Hospital University of Copenhagen Herlev Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d3lafur G\u00edsli","family":"J\u00f3nsson","sequence":"additional","affiliation":[{"name":"Children's Hospital Landspitali University Hospital Reykjav\u00edk Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrin","family":"Palk","sequence":"additional","affiliation":[{"name":"Department of Hematology North Estonia Medical Centre Tallinn Estonia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaie","family":"Pruunsild","sequence":"additional","affiliation":[{"name":"Kaie Pruunsild Tallinn Children's Hospital Tallinn Estonia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petter","family":"Quist\u2010Paulsen","sequence":"additional","affiliation":[{"name":"Department of Hematology St. Olav's Hospital Trondheim University Hospital Trondheim Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Goda","family":"Vaitkeviciene","sequence":"additional","affiliation":[{"name":"Centre for Pediatric Oncology and Hematology Children's Hospital Affiliate of Vilnius University Hospital Santariskiu Klinikos Vilnius 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