{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T10:31:37Z","timestamp":1794047497106,"version":"4.8.0"},"reference-count":99,"publisher":"Ferrata Storti Foundation (Haematologica)","issue":"9","license":[{"start":{"date-parts":[[2025,3,6]],"date-time":"2025-03-06T00:00:00Z","timestamp":1741219200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["haematol"],"abstract":"<jats:p>Most children diagnosed with acute lymphoblastic leukemia (ALL) will achieve remission and be cured of their disease. However, this high cure rate comes at the cost of acute and chronic treatment-related toxicities. In fact, of those who do not survive, a similar number of children die from either ALL itself or the toxicities associated with its treatment. Therapy- related toxicities, whether acute or chronic, can impact treatment efficacy, overall survival (OS), and the patient\u2019s quality of life. This review focused on six major acute toxicities of ALL therapy, venous thromboembolism, osteonecrosis, neurological sequelae, delayed methotrexate (MTX) elimination, asparaginase-associated pancreatitis, and toxicities resulting from the new biological therapies. Most of these severe acute toxicities of ALL treatment can be mitigated through tailored therapy adaptations for individual patients and careful incorporation of immunotherapy. These adaptations will soon become a central component of contemporary pediatric ALL protocols and ultimately improve patients\u2019 OS and wellness.<\/jats:p>","DOI":"10.3324\/haematol.2024.285702","type":"journal-article","created":{"date-parts":[[2025,3,6]],"date-time":"2025-03-06T03:39:37Z","timestamp":1741232377000},"page":"1923-1933","source":"Crossref","is-referenced-by-count":8,"title":["Acute therapy-related toxicities in pediatric acute lymphoblastic leukemia"],"prefix":"10.3324","volume":"110","author":[{"given":"Shlomit Barzilai","family":"Birenboim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ron","family":"Rabinowicz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1856","published-online":{"date-parts":[[2025,3,6]]},"reference":[{"key":"79222","doi-asserted-by":"crossref","unstructured":"Pui CH, Yang JJ, Hunger SP. 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Venous thromboembolism and its risk factors in children with acute lymphoblastic leukemia in Israel: a population-based study. Cancers (Basel). 2020; 12(10):2759.","DOI":"10.3390\/cancers12102759"},{"key":"79226","doi-asserted-by":"crossref","unstructured":"Mitchell L, Hoogendoorn H, Giles AR, Vegh P, Andrew M. Increased endogenous thrombin generation in children with acute lymphoblastic leukemia: risk of thrombotic complications in L-asparaginase-induced antithrombin III deficiency. Blood. 1994; 83(2):386-391.","DOI":"10.1182\/blood.V83.2.386.386"},{"key":"79227","doi-asserted-by":"crossref","unstructured":"Klaassen ILM, Lauw MN, Fiocco M. Venous thromboembolism in a large cohort of children with acute lymphoblastic leukemia: risk factors and effect on prognosis. Res Pract Thromb Haemost. 2019; 3(2):234-241.","DOI":"10.1002\/rth2.12182"},{"key":"79228","doi-asserted-by":"crossref","unstructured":"Pelland-Marcotte MC, Kulkarni K, Athale UH, Pole JD, Brand\u00e3o LR, Sung L. Thrombosis is associated with worse survival in children with acute lymphoblastic leukemia: a report from CYP-C. Am J Hematol. 2021; 96(7):796-804.","DOI":"10.1002\/ajh.26193"},{"key":"79229","doi-asserted-by":"crossref","unstructured":"Sutherland DE, Weitz IC, Liebman HA. Thromboembolic complications of cancer: epidemiology, pathogenesis, diagnosis, and treatment. Am J Hematol. 2003; 72(1):43-52.","DOI":"10.1002\/ajh.10263"},{"key":"79230","doi-asserted-by":"crossref","unstructured":"Barzilai-Birenboim S, Arad-Cohen N, Nirel R. Thrombophilia screening and thromboprophylaxis may benefit specific ethnic subgroups with paediatric acute lymphoblastic leukaemia. Br J Haematol. 2019; 184(6):994-998.","DOI":"10.1111\/bjh.15752"},{"key":"79231","doi-asserted-by":"crossref","unstructured":"Bhojwani D, Darbandi R, Pei D. Severe hypertriglyceridaemia during therapy for childhood acute lymphoblastic leukaemia. Eur J Cancer. 2014; 50(15):2685-2694.","DOI":"10.1016\/j.ejca.2014.06.023"},{"key":"79232","doi-asserted-by":"crossref","unstructured":"Rank CU, Toft N, Tuckuviene R. Thromboembolism in acute lymphoblastic leukemia: results of NOPHO ALL2008 protocol treatment in patients aged 1 to 45 years. Blood. 2018; 131(22):2475-2484.","DOI":"10.1182\/blood-2018-01-827949"},{"key":"79233","doi-asserted-by":"crossref","unstructured":"Prasca S, Carmona R, Ji L. Obesity and risk for venous thromboembolism from contemporary therapy for pediatric acute lymphoblastic leukemia. Thromb Res. 2018; 165:44-50.","DOI":"10.1016\/j.thromres.2018.02.150"},{"key":"79234","doi-asserted-by":"crossref","unstructured":"Athale UH, Flamand Y, Blonquist T. Predictors of thrombosis in children receiving therapy for acute lymphoblastic leukemia: results from Dana-Farber Cancer Institute ALL Consortium trial 05-001. Pediatr Blood Cancer. 2022; 69(8):e29581.","DOI":"10.1002\/pbc.29581"},{"key":"79235","doi-asserted-by":"crossref","unstructured":"Zheng Y, Yang W, Estepp J. Genomic analysis of venous thrombosis in children with acute lymphoblastic leukemia from diverse ancestries. Haematologica. 2024; 109(1):53-59.","DOI":"10.3324\/haematol.2022.281582"},{"key":"79236","doi-asserted-by":"crossref","unstructured":"Mateos MK, Tulstrup M, Quinn MC. Genome-wide association meta-analysis of single-nucleotide polymorphisms and symptomatic venous thromboembolism during therapy for acute lymphoblastic leukemia and lymphoma in Caucasian children. Cancers (Basel). 2020; 12(5):1285.","DOI":"10.3390\/cancers12051285"},{"key":"79237","doi-asserted-by":"crossref","unstructured":"Barg AA, Kenet G. Cancer-associated thrombosis in pediatric patients. Best Pract Res Clin Haematol. 2022; 35(1):101352.","DOI":"10.1016\/j.beha.2022.101352"},{"key":"79238","doi-asserted-by":"crossref","unstructured":"Hunault-Berger M, Chevallier P, Delain M. Changes in antithrombin and fibrinogen levels during induction chemotherapy with L-asparaginase in adult patients with acute lymphoblastic leukemia or lymphoblastic lymphoma. Haematologica. 2008; 93(10):1488-1494.","DOI":"10.3324\/haematol.12948"},{"key":"79239","doi-asserted-by":"crossref","unstructured":"Male C, Chait P, Andrew M. Central venous line-related thrombosis in children: association with central venous line location and insertion technique. Blood. 2003; 101(11):4273-4278.","DOI":"10.1182\/blood-2002-09-2731"},{"key":"79240","doi-asserted-by":"crossref","unstructured":"McLean TW, Fisher CJ, Snively BM, Chauvenet AR. Central venous lines in children with lesser risk acute lymphoblastic leukemia: optimal type and timing of placement. J Clin Oncol. 2005; 23(13):3024-3029.","DOI":"10.1200\/JCO.2005.12.097"},{"key":"79241","doi-asserted-by":"crossref","unstructured":"Revel-Vilk S, Yacobovich J, Tamary H. Risk factors for central venous catheter thrombotic complications in children and adolescents with cancer. Cancer. 2010; 116(17):4197-4205.","DOI":"10.1002\/cncr.25199"},{"key":"79242","doi-asserted-by":"crossref","unstructured":"Samji N, Bhatt MD, Kulkarni K. Challenges in management of VTE in children with cancer: risk factors and treatment options. Front Pediatr. 2022; 10:855162.","DOI":"10.3389\/fped.2022.855162"},{"key":"79243","doi-asserted-by":"crossref","unstructured":"Monagle P, Cuello CA, Augustine C. American Society of Hematology 2018 Guidelines for management of venous thromboembolism: treatment of pediatric venous thromboembolism. Blood Adv. 2018; 2(22):3292-3316.","DOI":"10.1182\/bloodadvances.2018024786"},{"key":"79244","doi-asserted-by":"crossref","unstructured":"Greiner J, Schrappe M, Claviez A. THROMBOTECT-a randomized study comparing low molecular weight heparin, antithrombin, and unfractionated heparin for thromboprophylaxis during induction therapy of acute lymphoblastic leukemia in children and adolescents. Haematologica. 2019; 104(4):756-765.","DOI":"10.3324\/haematol.2018.194175"},{"key":"79245","unstructured":"Male C, Lensing AWA, Palumbo JS. Rivaroxaban compared with standard anticoagulants for the treatment of acute venous thromboembolism in children: a randomized, controlled, phase 3 trial. Lancet Haematol. 2020; 7(1):e18-e27."},{"key":"79246","doi-asserted-by":"crossref","unstructured":"Halton J, Brand\u00e3o LR, Luciani M. Dabigatran etexilate for the treatment of acute venous thromboembolism in children (DIVERSITY): a randomized, controlled, open-label, phase 2b\/3, non-inferiority trial. Lancet Haematol. 2021; 8(1):e22-e33.","DOI":"10.2139\/ssrn.3624247"},{"key":"79247","doi-asserted-by":"crossref","unstructured":"O\u2019Brien SH, Rodriguez V, Lew G. Apixaban versus no anticoagulation for the prevention of venous thromboembolism in children with newly diagnosed acute lymphoblastic leukaemia or lymphoma (PREVAPIX-ALL): a phase 3, open-label, randomized, controlled trial. Lancet Haematol. 2024; 11(1):e27-e37.","DOI":"10.1016\/S2352-3026(23)00314-9"},{"key":"79248","doi-asserted-by":"crossref","unstructured":"Sala A, Mattano LA Jr, Barr RD. Osteonecrosis in children and adolescents with cancer-an adverse effect of systemic therapy. Eur J Cancer. 2007; 43(4):683-689.","DOI":"10.1016\/j.ejca.2006.11.002"},{"key":"79249","doi-asserted-by":"crossref","unstructured":"Amin NL, Feltbower R, Kinsey S, Vora A, James B. Osteonecrosis in patients with acute lymphoblastic leukaemia: a national questionnaire study. BMJ Paediatr Open. 2017; 1(1):e000122.","DOI":"10.1136\/bmjpo-2017-000122"},{"key":"79250","unstructured":"Aric\u00f2 M, Boccalatte MF, Silvestri D. Osteonecrosis: an emerging complication of intensive chemotherapy for childhood acute lymphoblastic leukemia. Haematologica. 2003; 88(7):747-753."},{"key":"79251","doi-asserted-by":"crossref","unstructured":"Patel B, Richards SM, Rowe JM, Goldstone AH, Fielding AK. High incidence of avascular necrosis in adolescents with acute lymphoblastic leukaemia: a UKALL XII analysis. Leukemia. 2008; 22(2):308-312.","DOI":"10.1038\/sj.leu.2405032"},{"key":"79252","doi-asserted-by":"crossref","unstructured":"te Winkel ML, Pieters R, Hop WC. Prospective study on incidence, risk factors, and long-term outcome of osteonecrosis in pediatric acute lymphoblastic leukemia. J Clin Oncol. 2011; 29(31):4143-4150.","DOI":"10.1200\/JCO.2011.37.3217"},{"key":"79253","doi-asserted-by":"crossref","unstructured":"Kuhlen M, Kunstreich M, Krull K, Meisel R, Borkhardt A. Osteonecrosis in children and adolescents with acute lymphoblastic leukemia: a therapeutic challenge. Blood Adv. 2017; 1(14):981-994.","DOI":"10.1182\/bloodadvances.2017007286"},{"key":"79254","doi-asserted-by":"crossref","unstructured":"Barzilai-Birenboim S, Yacobovich J, Zalcberg Y. Bone pain at leukemia diagnosis and other risk factors for symptomatic osteonecrosis in children with acute lymphoblastic leukemia. Pediatr Blood Cancer. 2021; 68(8):e29033.","DOI":"10.1002\/pbc.29033"},{"key":"79255","doi-asserted-by":"crossref","unstructured":"Powell C, Chang C, Gershwin ME. Current concepts on the pathogenesis and natural history of steroid-induced osteonecrosis. Clin Rev Allergy Immunol. 2011; 41(1):102-113.","DOI":"10.1007\/s12016-010-8217-z"},{"key":"79256","doi-asserted-by":"crossref","unstructured":"te Winkel ML, Pieters R, Wind EJ. Management and treatment of osteonecrosis in children and adolescents with acute lymphoblastic leukemia. Haematologica. 2014; 99(3):430-436.","DOI":"10.3324\/haematol.2013.095562"},{"key":"79257","doi-asserted-by":"crossref","unstructured":"Yin L, Li YB, Wang YS. Dexamethasone-induced adipogenesis in primary marrow stromal cell cultures: mechanism of steroid-induced osteonecrosis. Chin Med J (Engl). 2006; 119(7):581-588.","DOI":"10.1097\/00029330-200604010-00012"},{"key":"79258","doi-asserted-by":"crossref","unstructured":"Weinstein RS, Nicholas RW, Manolagas SC. Apoptosis of osteocytes in glucocorticoid-induced osteonecrosis of the hip. J Clin Endocrinol Metab. 2000; 85(8):2907-2912.","DOI":"10.1210\/jc.85.8.2907"},{"key":"79259","doi-asserted-by":"crossref","unstructured":"Mogensen SS, Harila-Saari A, M\u00e4kitie O. Comparing osteonecrosis clinical phenotype, timing, and risk factors in children and young adults treated for acute lymphoblastic leukemia. Pediatr Blood Cancer. 2018; 65(10):e27300.","DOI":"10.1002\/pbc.27300"},{"key":"79260","unstructured":"Marcus R. An expanded overview of postmenopausal osteoporosis. J Musculoskelet Neuronal Interact. 2002; 2(3):195-197."},{"key":"79261","doi-asserted-by":"crossref","unstructured":"Finch ER, Smith CA, Yang W. Asparaginase formulation impacts hypertriglyceridemia during therapy for acute lymphoblastic leukemia. Pediatr Blood Cancer. 2020; 67(1):e28040.","DOI":"10.1002\/pbc.28040"},{"key":"79262","doi-asserted-by":"crossref","unstructured":"Mogensen SS, Schmiegelow K, Grell K. Hyperlipidemia is a risk factor for osteonecrosis in children and young adults with acute lymphoblastic leukemia. Haematologica. 2017; 102(5):e175-e178.","DOI":"10.3324\/haematol.2016.160507"},{"key":"79263","doi-asserted-by":"crossref","unstructured":"Bond J, Hough R, Moppett J, Vora A, Mitchell C, Goulden N. \u2018Stroke-like syndrome\u2019 caused by intrathecal methotrexate in patients treated during the UKALL 2003 trial. Leukemia. 2013; 27(4):954-956.","DOI":"10.1038\/leu.2012.328"},{"key":"79264","doi-asserted-by":"crossref","unstructured":"Santangelo A, Bartolini E, Nuzzi G. The clinical impact of methotrexate-induced stroke-like neurotoxicity in pediatric departments: an Italian multi-centre case-series. Front Neurol. 2022; 13:920214.","DOI":"10.3389\/fneur.2022.920214"},{"key":"79265","doi-asserted-by":"crossref","unstructured":"Haykin ME, Gorman M, van Hoff J, Fulbright RK, Baehring JM. Diffusion-weighted MRI correlates of subacute methotrexate-related neurotoxicity. J Neurooncol. 2006; 76(2):153-157.","DOI":"10.1007\/s11060-005-4569-2"},{"key":"79266","doi-asserted-by":"crossref","unstructured":"Dhariwal N, Roy Moulik N, Smriti V, Dhamne C, Chichra A, Srinivasan S, Narula G, Banavali S. Clinico-radiological profile, management and follow-up of methotrexate-induced neurotoxicity in children with acute lymphoblastic leukemia. Leuk Lymphoma. 2023; 64(12):1971-1980.","DOI":"10.1080\/10428194.2023.2245093"},{"key":"79267","doi-asserted-by":"crossref","unstructured":"Lipton SA, Rosenberg PA. Excitatory amino acids as a final common pathway for neurologic disorders. N Engl J Med. 1994; 330(9):613-622.","DOI":"10.1056\/NEJM199403033300907"},{"key":"79268","doi-asserted-by":"crossref","unstructured":"Watanabe K, Arakawa Y, Oguma E. Characteristics of methotrexate-induced stroke-like neurotoxicity. Int J Hematol. 2018; 108(6):630-636.","DOI":"10.1007\/s12185-018-2525-0"},{"key":"79269","doi-asserted-by":"crossref","unstructured":"Vagace JM, Caceres-Marzal C, Jimenez M, Casado MS, Gonzalez de Murillo S, Gervasini G. Methotrexate-induced subacute neurotoxicity in a child with acute lymphoblastic leukemia carrying genetic polymorphisms related to folate homeostasis. Am J Hematol. 2011; 86(1):98-101.","DOI":"10.1002\/ajh.21897"},{"key":"79270","doi-asserted-by":"crossref","unstructured":"Cruz-Carreras MT, Chaftari P, Shamsnia A, Guha-Thakurta N, Gonzalez C. Methotrexate-induced leukoencephalopathy presenting as stroke in the emergency department. Clin Case Rep. 2017; 5(10):1644-1648.","DOI":"10.1002\/ccr3.1110"},{"key":"79271","doi-asserted-by":"crossref","unstructured":"Bernini JC, Fort DW, Griener JC, Kane BJ, Chappell WB, Kamen BA. Aminophylline for methotrexate-induced neurotoxicity. Lancet. 1995; 345(8949):544-547.","DOI":"10.1016\/S0140-6736(95)90464-6"},{"key":"79272","doi-asserted-by":"crossref","unstructured":"Bhojwani D, Sabin ND, Pei D. Methotrexate-induced neurotoxicity and leukoencephalopathy in childhood acute lymphoblastic leukemia. J Clin Oncol. 2014; 32(9):949-959.","DOI":"10.1200\/JCO.2013.53.0808"},{"key":"79273","doi-asserted-by":"crossref","unstructured":"Lin W, Xie J, Zhang J. Posterior reversible encephalopathy syndrome in children with acute lymphoblastic leukemia during remission induction chemotherapy: a single-center retrospective study. Minerva Pediatr (Torino). 2023; 75(6):808-816.","DOI":"10.23736\/S2724-5276.19.05675-5"},{"key":"79274","doi-asserted-by":"crossref","unstructured":"Anastasopoulou S, Eriksson MA, Heyman M. Posterior reversible encephalopathy syndrome in children with acute lymphoblastic leukemia: clinical characteristics, risk factors, course, and outcome of disease. Pediatr Blood Cancer. 2019; 66(5):e27594.","DOI":"10.1002\/pbc.27594"},{"key":"79275","doi-asserted-by":"crossref","unstructured":"Hayes J, Mahoney AB, Ayers C. A rare cause of posterior reversible encephalopathy syndrome: acute lymphoblastic leukemia. Clin Case Rep. 2023; 11(11):e8238.","DOI":"10.1002\/ccr3.8238"},{"key":"79276","doi-asserted-by":"crossref","unstructured":"Anastasopoulou S, Heyman M, Eriksson MA. Seizures during treatment of childhood acute lymphoblastic leukemia: a population-based cohort study. Eur J Paediatr Neurol. 2020; 27:72-77.","DOI":"10.1016\/j.ejpn.2020.04.004"},{"key":"79277","doi-asserted-by":"crossref","unstructured":"Banerjee JS, Heyman M, Palom\u00e4ki M. Posterior reversible encephalopathy syndrome: risk factors and impact on the outcome in children with acute lymphoblastic leukemia treated with Nordic protocols. J Pediatr Hematol Oncol. 2018; 40(1):e13-e18.","DOI":"10.1097\/MPH.0000000000001009"},{"key":"79278","doi-asserted-by":"crossref","unstructured":"Papayannidis C, Volpato F, Iacobucci I, Abbenante MC, Sartor C, Martinelli G. Posterior reversible encephalopathy syndrome in a B-cell acute lymphoblastic leukemia young adult patient treated with a pediatric-like chemotherapeutic schedule. Hematol Rep. 2014; 6(3):5565.","DOI":"10.4081\/hr.2014.5565"},{"key":"79279","doi-asserted-by":"crossref","unstructured":"Ghali MGZ, Davanzo J, Leo M, Rizk E. Posterior reversible encephalopathy syndrome in pediatric patients: pathophysiology, diagnosis, and management. Leuk Lymphoma. 2019; 60(10):2365-2372.","DOI":"10.1080\/10428194.2019.1594210"},{"key":"79280","doi-asserted-by":"crossref","unstructured":"Kim SJ, Im SA, Lee JW. Predisposing factors of posterior reversible encephalopathy syndrome in acute childhood leukemia. Pediatr Neurol. 2012; 47(6):436-442.","DOI":"10.1016\/j.pediatrneurol.2012.07.011"},{"key":"79281","doi-asserted-by":"crossref","unstructured":"Anastasopoulou S, Nielsen RL, Als-Nielsen B. Acute central nervous system toxicity during treatment of pediatric acute lymphoblastic leukemia: phenotypes, risk factors and genotypes. Haematologica. 2022; 107(10):2318-2328.","DOI":"10.3324\/haematol.2021.280016"},{"key":"79282","doi-asserted-by":"crossref","unstructured":"Moe PJ, Holen A. High-dose methotrexate in childhood acute lymphoblastic leukemia. Pediatr Hematol Oncol. 2000; 17(8):615-622.","DOI":"10.1080\/08880010050211321"},{"key":"79283","doi-asserted-by":"crossref","unstructured":"Widemann BC, Adamson PC. Understanding and managing methotrexate nephrotoxicity. Oncologist. 2006; 11(6):694-703.","DOI":"10.1634\/theoncologist.11-6-694"},{"key":"79284","doi-asserted-by":"crossref","unstructured":"Svahn T, Mellgren K, Harila-Saari A. Delayed elimination of high-dose methotrexate and use of carboxypeptidase G2 in pediatric patients during treatment for acute lymphoblastic leukemia. Pediatr Blood Cancer. 2017; 64(7)","DOI":"10.1002\/pbc.26395"},{"key":"79285","doi-asserted-by":"crossref","unstructured":"Gros L, Rold\u00e1n A, Cabero-Mart\u00ednez A. Incidence and management of patients with methotrexate delayed elimination in clinical practice: a Delphi study. 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Oncologist. 2016; 21(12):1471-1482.","DOI":"10.1634\/theoncologist.2015-0164"},{"key":"79289","doi-asserted-by":"crossref","unstructured":"Wasfey EF, Shaaban M, Essam M. Infliximab ameliorates methotrexate-induced nephrotoxicity in experimental rat model: impact on oxidative stress, mitochondrial biogenesis, apoptotic and autophagic machineries. Cell Biochem Biophys. 2023; 81(4):717-726.","DOI":"10.1007\/s12013-023-01168-7"},{"key":"79290","doi-asserted-by":"crossref","unstructured":"Abe K, Higurashi T, Takahashi M. Concomitant use of high-dose methotrexate and glycyrrhizin affects pharmacokinetics of methotrexate, resulting in hepatic toxicity. In Vivo. 2021; 35(4):2163-2169.","DOI":"10.21873\/invivo.12487"},{"key":"79291","doi-asserted-by":"crossref","unstructured":"Reiss SN, Buie LW, Adel N, Goldman DA, Devlin SM, Douer D. Hypoalbuminemia is significantly associated with increased clearance time of high-dose methotrexate in patients being treated for lymphoma or leukemia. 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Metabolites. 2021; 11(6):402.","DOI":"10.3390\/metabo11060402"},{"key":"79295","doi-asserted-by":"crossref","unstructured":"Pession A, Valsecchi MG, Masera G. Long-term results of a randomized trial on extended use of high-dose L-asparaginase for standard risk childhood acute lymphoblastic leukemia. J Clin Oncol. 2005; 23(28):7161-7167.","DOI":"10.1200\/JCO.2005.11.411"},{"key":"79296","doi-asserted-by":"crossref","unstructured":"Skipper MT, Albertsen BK, Schmiegelow K, Andr\u00e9s-Jensen L. Long-term effects of asparaginase-associated pancreatitis. Pediatr Blood Cancer. 2023; 70(6):e30528.","DOI":"10.1002\/pbc.30528"},{"key":"79297","doi-asserted-by":"crossref","unstructured":"Silverman LB, Gelber RD, Dalton VK. Improved outcome for children with acute lymphoblastic leukemia: results of Dana-Farber Consortium Protocol 91-01. 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