Clinical Impact of Corticosteroid-Induced Adrenal Suppression during Treatment for Acute Lymphoblastic Leukemia in Children: A Prospective Observational Study Using the Low-Dose Adrenocorticotropin Test

High-dose glucocorticoid therapy may cause adrenal suppression lasting more than 1 week in children with acute lymphoblastic leukemia, even after tapering the dose. We suggest steroid replacement during stress episodes within 1 to 2 weeks after discontinuation and thereafter testing adrenal function selectively in accordance with symptoms.