Chemotherapy-related toxicity in childhood neoplasia

To evaluate the incidence and time of occurrence of chemotherapy-related toxic events in 100 children admitted to the Hematology-Oncology Ward of "Sfanta Maria" Children's Emergency Hospital in Iasi, Romania, over a 4-year period.

An analytical, descriptive and comparative, retrospective and prospective study covering a 4-year period on the incidence of chemotherapy side effects, was performed on 100 children admitted for solid tumors or hematologic malignancies. The probability of each adverse event to appear and the time period from chemotherapy initiation to the moment of side effect appearance were assessed.

The most frequent toxicity was alopecia (79.5%), followed by medullary aplasia (71.1%), oral candidiasis (65.3%), diarrhea and emesis (64% each), toxic hepatitis (61%), and Cushing's syndrome (21.5%). Oral herpes and thrush were less frequent (13.2% and 12.2%, respectively). Remissions of the underlying disease were achieved in 69.9% of the cases. Alopecia, medullary aplasia and oral candidiasis developed during the first 14 months of treatment. Mucositis, emetic syndrome and toxic hepatitis were diagnosed within the first 12 months of treatment. Diarrhea and oral herpes or thrush appeared during the first 15 months, while Cushing's syndrome developed during the first 6 months. All remissions were obtained during the first 4 months of treatment.

While alopecia and medullary aplasia were the most frequent side effects of chemotherapy in our study group, the earliest were Cushing's syndrome, emetic syndrome and toxic hepatitis.