Background: Chemotherapy accounts to high vulnerability toward Adverse Events (AEs) as it involves highly complicated regimens. Objective of the study is to identify, assess, grade and categorize chemotherapy-induced adverse drug reactions in pediatric oncology. Materials and Methods: A 6 months Prospective-observational study was conducted in pediatric hematology oncology department. 0-15 years of hospitalized patients receiving chemotherapy for cancer were enrolled. Demographic details, cytotoxic drugs used and AEs that occurred were collected in a self-designed patient profile form. AEs were studied using CTCAE version 4.03 and Naranjo's Scale of Probability. After each cycle, follow ups were taken. Result: A total of 50 patients, of which 33 male and 17 female patients were included in the study and a total of 332 AEs were observed. AEs were segregated into organ class and the number of events observed were, Gastrointestinal (123), General Disorders (107), Musculoskeletal (23) be caused by more than one chemotherapeutic drug. Using Naranjo's Scale we observed, 6 were definite, 159 were probable and 167 were possible. On using CTCAE, out of 332 AEs, 167 were characterized as Grade 1, 114 as Grade 2, 51 as Grade 3 and 1 as Grade 5. Conclusion: Using CTCAE, most AEs were suspected to have been caused because of Daunorubicin and Methotrexate, but the severe AEs (neurotoxicity, pulmonary toxicity) were due to Vincristine, Methotrexate, and Cyclophosphamide.

The unending morbidity and mortality that results from cancer, as well as adverse reactions due to chemotherapy and the enormous economic burden of treatment and hospitalization, advocates for the necessity of chemopreventive measures. Cancer chemoprevention refers to the use of agents capable of reversing, reducing, or slowing down the pathology of cancer at various stages. Fortunately, a few therapeutic drugs with relatively low toxicity (e.g., tamoxifen, finasteride), and a sparse number of vaccines (hepatitis B, HPV), are used to prevent specific cancers. In the general population, however, therapeutic options for cancer prevention are not common. Nonetheless, it is generally agreed that diet affects the genesis of cancer, and phytochemicals have the capacity of functioning as cancer chemoprevention agents. This is supported by epidemiological studies and clearly documented with animal models designed to mimic human carcinogenesis. Additionally, some public health strategies, such as recommendations for greater consumption of fruits and vegetables, reflect the merits of cancer chemoprevention. Here, we focus on some well-established natural product cancer chemopreventive agents, including resveratrol (grapes), epigallocatechin-3-gallate (green tea), sulforaphane (cruciferous vegetables), anthocyanins (grapes and berries), curcumin (turmeric), silibinin (milk thistle), and lycopene (tomatoes). As aptly demonstrated by genomic analysis and other methods, the mechanistic underpinning is variable and complex. In addition, responses may be mediated through indirect mechanisms, such as interaction with the microbiome. Furthermore, ancillary applications of chemopreventive agents are worthy of consideration, such as management of sequelae induced by chemotherapy. Recognizing the loss of millions of cancer patients every year, it is obvious that negating malignant metastatic conditions remains of paramount importance. In meeting this objective, cancer chemoprevention offers great promise.