Abstract
Relevance: The primary goal of antineoplastic therapy is to achieve maximum therapeutic efficacy with minimal toxicity. Supportive care in oncohematology encompasses a range of measures aimed at preventing or minimizing complications and adverse effects associated with polychemotherapy.This review aims to analyze the principles of supportive therapy and treatment-related toxicity in pediatric acute leukemias based on published literature.Materials and Methods: A comprehensive literature search was conducted using PubMed, Scopus, Embase, Cochrane Library, Web of Science, Google Scholar, and ClinicalTrials.gov to identify scientific publications on supportive care and treatment-related toxicity in pediatric acute leukemias. The search keywords included “acute lymphoblastic leukemia,” “acute myeloblastic leukemia,” “supportive care,” “treatment toxicity,” and “children.”Results: This article provides a literature review and addresses the most challenging issues in the diagnosis and management of chemotherapy-related adverse effects in children with acute leukemias, including acute tumor lysis syndrome, febrile neutropenia, agranulocytosis, electrolyte disturbances, and transfusion therapy. Particular attention is given to complications arising from the administration of high-dose methotrexate and agents such as L-asparaginase, cyclophosphamide, vincristine, and glucocorticosteroids within the supportive care framework.Conclusion: An essential aspect of protocol-based therapy is its delivery with a minimal number of adverse effects. Achieving this requires strict adherence to the principles of supportive care. Thanks to modern intensive treatment regimens, a thorough understanding of drug-related adverse effects, and the use of appropriate supportive care, it is possible to achieve long-term relapse-free survival in children with acute leukemias.