ReviewThe Lancet. Oncology2010
Glucocorticoid use in acute lymphoblastic leukaemia.
Review in The Lancet. Oncology, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 178 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
178 citing papers in PubMed, 5 syntheses or guidelines pooled it, 357 citations in OpenAlex.
- Evolving Paradigms in Chronic Graft-Versus-Host Disease: From Global Immunosuppression to Precision Targeted and Cell-Based Therapies.Stem cell reviews and reports · 2026Pooled it
- Thrombosis-Associated Risk Factors in Pediatrics and Adults Treated with Asparaginase-Containing Chemotherapy for ALL: A Systematic Review and Meta-Analysis.Current oncology (Toronto, Ont.) · 2026Pooled it
- Risk factors for steroid-induced adverse psychological reactions and sleep problems in pediatric acute lymphoblastic leukemia: A systematic review.Psycho-oncology · 2021Pooled it
- Management of adult and paediatric acute lymphoblastic leukaemia in Asia: resource-stratified guidelines from the Asian Oncology Summit 2013.The Lancet. Oncology · 2013Guideline
- Systematic review and meta-analysis of randomized trials of central nervous system directed therapy for childhood acute lymphoblastic leukemia.Pediatric blood & cancer · 2013Pooled it
- Physical fitness and clinically assessed disease burden in long-term childhood cancer survivors-The SURfit study.Cancer · 2025Trial
- Development of osteonecrosis and improved survival in B-ALL: results of Children's Oncology Group Trial AALL0232.Leukemia · 2024Trial
- Evaluation of the pharmacokinetics of prednisolone in paediatric patients with acute lymphoblastic leukaemia treated according to Dutch Childhood Oncology Group protocols and its relation to treatment response.British journal of haematology · 2021Trial
- Trial
- Neuropsychological outcomes of a randomized trial of prednisone versus dexamethasone in acute lymphoblastic leukemia: findings from Dana-Farber Cancer Institute All Consortium Protocol 00-01.Pediatric blood & cancer · 2013Trial
- Improved prognosis for older adolescents with acute lymphoblastic leukemia.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2011Trial
- Gradient-driven microfluidic framework for the screening of ratiometric drug combinations towards precision oncology in paediatric leukaemia.Nature biomedical engineering · 2026Article
- Diagnostic BMI and Induction Therapy Weight Change Associated With Hepatotoxicity in Pediatric Patients With Acute Lymphoblastic Leukemia.Cancer medicine · 2026Article
- Signaling Under Stress: Targeting the Glucocorticoid Receptor in Cancer.Cancer research · 2026Review
- Spontaneous regression of B-cell acute lymphoblastic leukemia with PAX5 alterations at relapse: a case report.Annals of hematology · 2026Article
- Article
- Corticosteroid-associated osteonecrosis in paediatric compared with adult patients: are they the same disease?Bone & joint open · 2026Article
- Left ventricular function and its longitudinal change in Swiss childhood cancer survivors - results from the CardioOnco study.Cardio-oncology (London, England) · 2026Article
- NFATc1 and NFATc2 regulate glucocorticoid resistance in pediatric T-cell acute lymphoblastic leukemia through modulation of cholesterol biosynthesis and the WNT/β-catenin pathway.Haematologica · 2026Article
- The role of pharmacogenetics in the therapy regimen of acute lymphoblastic leukemia in children: recent discoveries and future perspectives.Pharmacological reports : PR · 2026Review
118 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 1 institution in 1 country.
Funding
Abstract
Glucocorticoids (prednisone and dexamethasone) play an essential part in the treatment of acute lymphoblastic leukaemia (ALL), but their optimum doses and bioequivalence have not been established. Results of preclinical studies have shown that dexamethasone has a longer half-life and better CNS penetration than does prednisone. In prospective randomised trials, dexamethasone improved control of CNS leukaemia. At a prednisone-to-dexamethasone dose ratio of less than seven, dexamethasone (6-18 mg/m(2) per day) resulted in a better event-free survival than did prednisone (40-120 mg/m(2) per day), and high-dose dexamethasone (10-18 mg/m(2) per day) improved the outcome of T-cell ALL and high-risk ALL. However, dexamethasone caused more adverse effects, including infection, bone fracture, osteonecrosis, mood and behaviour problems, and myopathy. At a dose ratio greater than seven, the two drugs showed no difference in efficacy. Therefore, the efficacy of prednisone and dexamethasone is dose dependent and needs to be carefully assessed against the toxic effects. Moreover, although dexamethasone generally showed increased activity in ALL cells in vitro, the dose ratio of the two drugs that exerted equivalent cytotoxic effects differed substantially in samples from individuals. The selection of the type and dose of glucocorticoid should be based on the risk of relapse, treatment phase, and the chemotherapeutic drugs used concomitantly.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.