Risk factors for toxicity
| Etiology and risk factors . |
|---|
| Inherent |
| Syndromes5 |
| Down syndrome (increased risk of gastrointestinal toxicity and infections) |
| Li Fraumeni (increased risk of induction death, death in remission, and second malignancies) |
| Ataxia telangiectasia (increased risk of toxic death, cyclophosphamide-induced cystitis, and second malignancies) |
| Polymorphisms |
| GSTP1, MTHFR, SHMT1 (methotrexate encephalopathy)22 |
| RGS6, UKL2, ASNS, CPA2 (pancreatitis)31,33 |
| TPMT, NUDT15 (6-mercaptopurine toxicity)46,47 |
| Acquired |
| Age (discussed below) |
| Preexisting comorbidities |
| Obesity (particularly avascular necrosis) |
| Regimen intensity, including allogeneic transplant |
| Presence of central venous catheter (line-related infection, thrombosis) |
| Exposure to specific drugs |
| Etiology and risk factors . |
|---|
| Inherent |
| Syndromes5 |
| Down syndrome (increased risk of gastrointestinal toxicity and infections) |
| Li Fraumeni (increased risk of induction death, death in remission, and second malignancies) |
| Ataxia telangiectasia (increased risk of toxic death, cyclophosphamide-induced cystitis, and second malignancies) |
| Polymorphisms |
| GSTP1, MTHFR, SHMT1 (methotrexate encephalopathy)22 |
| RGS6, UKL2, ASNS, CPA2 (pancreatitis)31,33 |
| TPMT, NUDT15 (6-mercaptopurine toxicity)46,47 |
| Acquired |
| Age (discussed below) |
| Preexisting comorbidities |
| Obesity (particularly avascular necrosis) |
| Regimen intensity, including allogeneic transplant |
| Presence of central venous catheter (line-related infection, thrombosis) |
| Exposure to specific drugs |