Acute Toxicity and Late Effects Related to Acute Lymphoblastic Leukemia Treatment

Improved treatment strategies for childhood ALL over the past decades have resulted in dramatically increased survival rates now exceeding 90%. However, antileukemic treatment interferes not only with malignant cells but also with the function of normal tissue and organs resulting in both acute and long-term toxicities. The toxicity patterns have changed in parallel with antileukemic treatment, but the burden of toxicities remains high. Despite decades-long awareness of treatment-related morbidity, the lack of consensus-based capturing of late effects hampers the quantification of the total treatment-related health burden of relevance for a continuously growing population of survivors. This chapter presents the most prevalent acute toxicities as well as late effects related to recent and current ALL treatment and provides directions for future research.