Grade 3 to 5 toxicities following induction and consolidation phases
| Type of toxicity . | Induction (n = 68) . | Consolidation (n = 60) . | ||||
|---|---|---|---|---|---|---|
| Grade 3 . | Grade 4 . | Grade 5 . | Grade 3 . | Grade 4 . | Grade 5 . | |
| Neutropenia∗ | 8 (12%) | 53 (78%) | — | 8 (13%) | 37 (62%) | — |
| Anemia | 26 (38%) | 8 (12%) | — | 18 (30%) | 1 (2%) | — |
| Thrombocytopenia | 10 (15%) | 23 (34%) | — | 4 (7%) | 40 (67%) | — |
| FN/bacterial infections | 20 (29%) | 3 (4%) | 5 (7%)† | 17 (28%) | 0 (0%) | 1 (2%)†,‡ |
| CMV reactivation | 3 (4%) | 0 (0%) | — | 1 (2%) | 0 (0%) | — |
| Hepatotoxicity | 8 (12%) | 1 (1%) | — | 1 (2%) | 0 (0%) | — |
| Mucositis | 7 (10%) | 4 (6%) | — | 1 (2%) | 0 (0%) | — |
| Diarrhea | 1 (1%) | 0 (0%) | — | 3 (5%) | 1 (2%) | — |
| Bowel obstruction | 0 (0%) | 0 (0%) | — | 0 (0%) | 1 (2%) | — |
| Cardiotoxicity | 0 (0%) | 0 (0%) | — | 0 (0%) | 2 (3%)§ | — |
| Stroke | 0 (0%) | 0 (0%) | — | 0 (0%) | 1 (2%) | — |
| Type of toxicity . | Induction (n = 68) . | Consolidation (n = 60) . | ||||
|---|---|---|---|---|---|---|
| Grade 3 . | Grade 4 . | Grade 5 . | Grade 3 . | Grade 4 . | Grade 5 . | |
| Neutropenia∗ | 8 (12%) | 53 (78%) | — | 8 (13%) | 37 (62%) | — |
| Anemia | 26 (38%) | 8 (12%) | — | 18 (30%) | 1 (2%) | — |
| Thrombocytopenia | 10 (15%) | 23 (34%) | — | 4 (7%) | 40 (67%) | — |
| FN/bacterial infections | 20 (29%) | 3 (4%) | 5 (7%)† | 17 (28%) | 0 (0%) | 1 (2%)†,‡ |
| CMV reactivation | 3 (4%) | 0 (0%) | — | 1 (2%) | 0 (0%) | — |
| Hepatotoxicity | 8 (12%) | 1 (1%) | — | 1 (2%) | 0 (0%) | — |
| Mucositis | 7 (10%) | 4 (6%) | — | 1 (2%) | 0 (0%) | — |
| Diarrhea | 1 (1%) | 0 (0%) | — | 3 (5%) | 1 (2%) | — |
| Bowel obstruction | 0 (0%) | 0 (0%) | — | 0 (0%) | 1 (2%) | — |
| Cardiotoxicity | 0 (0%) | 0 (0%) | — | 0 (0%) | 2 (3%)§ | — |
| Stroke | 0 (0%) | 0 (0%) | — | 0 (0%) | 1 (2%) | — |
FN, febbrile neutropenia; CMV, citomegalovirus.
All patients received Granulocyte-stimulating factor after methotrexate (day 21) and etoposide (day 15) delivery.
These 6 grade 5 infections were only treatment discontinuations secondary to toxicity.
One patient died of acute respiratory distress syndrome without documented infection.
Grade 4 cardiotoxicity consisted of heart failure and atrial fibrillation.