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NCT02393859 · OUTCOME

Number of Participants With TEAEs of Interest

Phase 3 Trial of Blinatumomab vs Standard Chemotherapy in Pediatric Subjects With HIgh-Risk (HR) First Relapse B-precursor Acute Lymphoblastic Leukemia (ALL) · Source last updated 2026-06-26

Results reported by the registry submitting party. Population, time horizon, units and missing values must be read together.

Measure
NUMBER
Unit
participants
Interval / dispersion
Not reported
Time frame
From first dose of IP through the last dose of IP (up to Day 29) plus 30 days.

What was measured

TEAEs of interest included capillary leak syndrome (CLS), cytokine release syndrome (CRS), decreased immunoglobulins (DI), elevated liver enzymes (ELE), embolic and thrombotic events (ETE), infections (INF), infusion reactions without considering duration (IRWCD), medication errors (ME), neurologic events (NE), neutropenia and febrile neutropenia (NFN), pancreatitis (PNC), tumor lysis syndrome, leukoencephalopathy, immunogenicity. Severity was graded according to the CTCAE version 4.03: 1=mild, 2=moderate, 3=severe, 4=life-threatening, 5=death.

Analysis population: Safety Analysis Set: who received protocol-specified therapy analyzed according to the treatment they received.

Groups in this outcome

HC3 Chemotherapy

One week of treatment with HC3 followed by 3 weeks of no treatment. The standard intensive consolidation chemotherapy course HC3 includes dexamethasone (10 mg/m\^2/day IV on Days 1-6), vincrisitne (1.5 mg/m\^2/day IV on Days 1 and 6), daunorubicin (30 mg/m\^2 IV over 24 hours on Day 5), methotrexate (1 g/m\^2 IV over 36 hours on Day 1), ifosfamide (800 mg/m\^2 IV for 1 hour on Days 2-4), and pegylated \[PEG\]-asparaginase (1000 U/m\^2 IV for 2 hours or IM on Day 6) or, if allergic, erwinia-asparaginase (20,000 units/m\^2 IV or IM every 48 hours for a total of 6 doses).

Blinatumomab

One 4-week cycle of blinatumomab 15 μg/m\^2/day as a continuous intravenous infusion (CIVI).

Group identifiers and denominators belong to this outcome only. They may differ in another outcome or in safety reporting.

Analysis denominator · Participants

GroupSource count
HC3 Chemotherapy52
Blinatumomab54

Reported measurements

CLS Events
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy1Not reportedNot reportedNot reportedNot reported
Blinatumomab0Not reportedNot reportedNot reportedNot reported
CLS Events Grade ≥ 3
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy1Not reportedNot reportedNot reportedNot reported
Blinatumomab0Not reportedNot reportedNot reportedNot reported
Serious CLS Events
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy1Not reportedNot reportedNot reportedNot reported
Blinatumomab0Not reportedNot reportedNot reportedNot reported
Fatal CLS Events
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy0Not reportedNot reportedNot reportedNot reported
Blinatumomab0Not reportedNot reportedNot reportedNot reported
CLS Events Leading to Discontinuation of IP
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy0Not reportedNot reportedNot reportedNot reported
Blinatumomab0Not reportedNot reportedNot reportedNot reported
CLS Events Leading to Interruption of IP
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy0Not reportedNot reportedNot reportedNot reported
Blinatumomab0Not reportedNot reportedNot reportedNot reported
CRS Events
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy1Not reportedNot reportedNot reportedNot reported
Blinatumomab2Not reportedNot reportedNot reportedNot reported
CRS Events Grade ≥ 3
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy0Not reportedNot reportedNot reportedNot reported
Blinatumomab0Not reportedNot reportedNot reportedNot reported
Serious CRS Events
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy0Not reportedNot reportedNot reportedNot reported
Blinatumomab0Not reportedNot reportedNot reportedNot reported
Fatal CRS Events
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy0Not reportedNot reportedNot reportedNot reported
Blinatumomab0Not reportedNot reportedNot reportedNot reported
CRS Events Leading to Discontinuation of IP
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy0Not reportedNot reportedNot reportedNot reported
Blinatumomab0Not reportedNot reportedNot reportedNot reported
CRS Events Leading to Interruption of IP
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy0Not reportedNot reportedNot reportedNot reported
Blinatumomab0Not reportedNot reportedNot reportedNot reported
DI Events
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy6Not reportedNot reportedNot reportedNot reported
Blinatumomab9Not reportedNot reportedNot reportedNot reported
DI Events Grade ≥ 3
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy1Not reportedNot reportedNot reportedNot reported
Blinatumomab1Not reportedNot reportedNot reportedNot reported
Serious DI Events
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy0Not reportedNot reportedNot reportedNot reported
Blinatumomab1Not reportedNot reportedNot reportedNot reported
Fatal DI Events
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy0Not reportedNot reportedNot reportedNot reported
Blinatumomab0Not reportedNot reportedNot reportedNot reported
DI Events Leading to Discontinuation of IP
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy0Not reportedNot reportedNot reportedNot reported
Blinatumomab0Not reportedNot reportedNot reportedNot reported
DI Events Leading to Interruption of IP
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy0Not reportedNot reportedNot reportedNot reported
Blinatumomab0Not reportedNot reportedNot reportedNot reported
ELE Events
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy15Not reportedNot reportedNot reportedNot reported
Blinatumomab7Not reportedNot reportedNot reportedNot reported
ELE Events Grade ≥ 3
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy9Not reportedNot reportedNot reportedNot reported
Blinatumomab3Not reportedNot reportedNot reportedNot reported
Serious ELE Events
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy1Not reportedNot reportedNot reportedNot reported
Blinatumomab0Not reportedNot reportedNot reportedNot reported
Fatal ELE Events
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy0Not reportedNot reportedNot reportedNot reported
Blinatumomab0Not reportedNot reportedNot reportedNot reported
ELE Events Leading to Discontinuation of IP
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy0Not reportedNot reportedNot reportedNot reported
Blinatumomab0Not reportedNot reportedNot reportedNot reported
ELE Events Leading to Interruption of IP
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy0Not reportedNot reportedNot reportedNot reported
Blinatumomab0Not reportedNot reportedNot reportedNot reported
ETE Events
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy0Not reportedNot reportedNot reportedNot reported
Blinatumomab4Not reportedNot reportedNot reportedNot reported
ETE Events Grade ≥ 3
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy0Not reportedNot reportedNot reportedNot reported
Blinatumomab2Not reportedNot reportedNot reportedNot reported
Serious ETE Events
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy0Not reportedNot reportedNot reportedNot reported
Blinatumomab0Not reportedNot reportedNot reportedNot reported
Fatal ETE Events
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy0Not reportedNot reportedNot reportedNot reported
Blinatumomab0Not reportedNot reportedNot reportedNot reported
ETE Events Leading to Discontinuation of IP
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy0Not reportedNot reportedNot reportedNot reported
Blinatumomab0Not reportedNot reportedNot reportedNot reported
ETE Events Leading to Interruption of IP
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy0Not reportedNot reportedNot reportedNot reported
Blinatumomab0Not reportedNot reportedNot reportedNot reported
INF Events
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy18Not reportedNot reportedNot reportedNot reported
Blinatumomab25Not reportedNot reportedNot reportedNot reported
INF Events Grade ≥ 3
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy6Not reportedNot reportedNot reportedNot reported
Blinatumomab11Not reportedNot reportedNot reportedNot reported
Serious INF Events
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy6Not reportedNot reportedNot reportedNot reported
Blinatumomab4Not reportedNot reportedNot reportedNot reported
Fatal INF Events
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy0Not reportedNot reportedNot reportedNot reported
Blinatumomab0Not reportedNot reportedNot reportedNot reported
IFN Events Leading to Discontinuation of IP
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy0Not reportedNot reportedNot reportedNot reported
Blinatumomab0Not reportedNot reportedNot reportedNot reported
IFN Events Leading to Interruption of IP
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy0Not reportedNot reportedNot reportedNot reported
Blinatumomab0Not reportedNot reportedNot reportedNot reported
IRWCD Events
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy4Not reportedNot reportedNot reportedNot reported
Blinatumomab37Not reportedNot reportedNot reportedNot reported
IRWCD Events Grade ≥ 3
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy0Not reportedNot reportedNot reportedNot reported
Blinatumomab2Not reportedNot reportedNot reportedNot reported
Serious IRWCD Events
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy0Not reportedNot reportedNot reportedNot reported
Blinatumomab1Not reportedNot reportedNot reportedNot reported
Fatal IRWCD Events
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy0Not reportedNot reportedNot reportedNot reported
Blinatumomab0Not reportedNot reportedNot reportedNot reported
IRWCD Events Leading to Discontinuation of IP
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy0Not reportedNot reportedNot reportedNot reported
Blinatumomab0Not reportedNot reportedNot reportedNot reported
IRWCD Events Leading to Interruption of IP
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy0Not reportedNot reportedNot reportedNot reported
Blinatumomab0Not reportedNot reportedNot reportedNot reported
ME Events
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy0Not reportedNot reportedNot reportedNot reported
Blinatumomab1Not reportedNot reportedNot reportedNot reported
ME Events Grade ≥ 3
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy0Not reportedNot reportedNot reportedNot reported
Blinatumomab0Not reportedNot reportedNot reportedNot reported
Serious ME Events
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy0Not reportedNot reportedNot reportedNot reported
Blinatumomab1Not reportedNot reportedNot reportedNot reported
Fatal ME Events
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy0Not reportedNot reportedNot reportedNot reported
Blinatumomab0Not reportedNot reportedNot reportedNot reported
ME Events Leading to Discontinuation of IP
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy0Not reportedNot reportedNot reportedNot reported
Blinatumomab0Not reportedNot reportedNot reportedNot reported
ME Events Leading to Interruption of IP
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy0Not reportedNot reportedNot reportedNot reported
Blinatumomab1Not reportedNot reportedNot reportedNot reported
NE Events
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy15Not reportedNot reportedNot reportedNot reported
Blinatumomab26Not reportedNot reportedNot reportedNot reported
NE Events Grade ≥ 3
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy1Not reportedNot reportedNot reportedNot reported
Blinatumomab3Not reportedNot reportedNot reportedNot reported
Serious NE Events
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy1Not reportedNot reportedNot reportedNot reported
Blinatumomab5Not reportedNot reportedNot reportedNot reported
Fatal NE Events
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy0Not reportedNot reportedNot reportedNot reported
Blinatumomab0Not reportedNot reportedNot reportedNot reported
NE Events Leading to Discontinuation of IP
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy0Not reportedNot reportedNot reportedNot reported
Blinatumomab2Not reportedNot reportedNot reportedNot reported
NE Events Leading to Interruption of IP
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy1Not reportedNot reportedNot reportedNot reported
Blinatumomab3Not reportedNot reportedNot reportedNot reported
NFN Events
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy28Not reportedNot reportedNot reportedNot reported
Blinatumomab12Not reportedNot reportedNot reportedNot reported
NFN Events Grade ≥ 3
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy27Not reportedNot reportedNot reportedNot reported
Blinatumomab11Not reportedNot reportedNot reportedNot reported
Serious NFN Events
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy12Not reportedNot reportedNot reportedNot reported
Blinatumomab0Not reportedNot reportedNot reportedNot reported
Fatal NFN Events
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy0Not reportedNot reportedNot reportedNot reported
Blinatumomab0Not reportedNot reportedNot reportedNot reported
NFN Events Leading to Discontinuation of IP
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy0Not reportedNot reportedNot reportedNot reported
Blinatumomab0Not reportedNot reportedNot reportedNot reported
NFN Events Leading to Interruption of IP
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy0Not reportedNot reportedNot reportedNot reported
Blinatumomab0Not reportedNot reportedNot reportedNot reported
PNC Events
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy1Not reportedNot reportedNot reportedNot reported
Blinatumomab0Not reportedNot reportedNot reportedNot reported
PNC Events Grade ≥ 3
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy1Not reportedNot reportedNot reportedNot reported
Blinatumomab0Not reportedNot reportedNot reportedNot reported
Serious PNC Events
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy1Not reportedNot reportedNot reportedNot reported
Blinatumomab0Not reportedNot reportedNot reportedNot reported
Fatal PNC Events
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy0Not reportedNot reportedNot reportedNot reported
Blinatumomab0Not reportedNot reportedNot reportedNot reported
PNC Events Leading to Discontinuation of IP
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy0Not reportedNot reportedNot reportedNot reported
Blinatumomab0Not reportedNot reportedNot reportedNot reported
PNC Events Leading to Interruption of IP
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy0Not reportedNot reportedNot reportedNot reported
Blinatumomab0Not reportedNot reportedNot reportedNot reported
Tumour Lysis Syndrome Events
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy0Not reportedNot reportedNot reportedNot reported
Blinatumomab0Not reportedNot reportedNot reportedNot reported
Leukoencephalopathy Events
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy0Not reportedNot reportedNot reportedNot reported
Blinatumomab0Not reportedNot reportedNot reportedNot reported
Immunogenicity Events
Values in participants · Interval/dispersion: Not reported
GroupValueSpreadLowerUpperComment
HC3 Chemotherapy0Not reportedNot reportedNot reportedNot reported
Blinatumomab0Not reportedNot reportedNot reportedNot reported
Complete source fields
classes
  1. categories
    1. measurements
      1. group Id
        OG000
        value
        1
      2. group Id
        OG001
        value
        0
    title
    CLS Events
  2. categories
    1. measurements
      1. group Id
        OG000
        value
        1
      2. group Id
        OG001
        value
        0
    title
    CLS Events Grade ≥ 3
  3. categories
    1. measurements
      1. group Id
        OG000
        value
        1
      2. group Id
        OG001
        value
        0
    title
    Serious CLS Events
  4. categories
    1. measurements
      1. group Id
        OG000
        value
        0
      2. group Id
        OG001
        value
        0
    title
    Fatal CLS Events
  5. categories
    1. measurements
      1. group Id
        OG000
        value
        0
      2. group Id
        OG001
        value
        0
    title
    CLS Events Leading to Discontinuation of IP
  6. categories
    1. measurements
      1. group Id
        OG000
        value
        0
      2. group Id
        OG001
        value
        0
    title
    CLS Events Leading to Interruption of IP
  7. categories
    1. measurements
      1. group Id
        OG000
        value
        1
      2. group Id
        OG001
        value
        2
    title
    CRS Events
  8. categories
    1. measurements
      1. group Id
        OG000
        value
        0
      2. group Id
        OG001
        value
        0
    title
    CRS Events Grade ≥ 3
  9. categories
    1. measurements
      1. group Id
        OG000
        value
        0
      2. group Id
        OG001
        value
        0
    title
    Serious CRS Events
  10. categories
    1. measurements
      1. group Id
        OG000
        value
        0
      2. group Id
        OG001
        value
        0
    title
    Fatal CRS Events
  11. categories
    1. measurements
      1. group Id
        OG000
        value
        0
      2. group Id
        OG001
        value
        0
    title
    CRS Events Leading to Discontinuation of IP
  12. categories
    1. measurements
      1. group Id
        OG000
        value
        0
      2. group Id
        OG001
        value
        0
    title
    CRS Events Leading to Interruption of IP
denoms
  1. counts
    1. group Id
      OG000
      value
      52
    2. group Id
      OG001
      value
      54
    units
    Participants
description
TEAEs of interest included capillary leak syndrome (CLS), cytokine release syndrome (CRS), decreased immunoglobulins (DI), elevated liver enzymes (ELE), embolic and thrombotic events (ETE), infections (INF), infusion reactions without considering duration (IRWCD), medication errors (ME), neurologic events (NE), neutropenia and febrile neutropenia (NFN), pancreatitis (PNC), tumor lysis syndrome, leukoencephalopathy, immunogenicity. Severity was graded according to the CTCAE version 4.03: 1=mild, 2=moderate, 3=severe, 4=life-threatening, 5=death.
groups
  1. description
    One week of treatment with HC3 followed by 3 weeks of no treatment. The standard intensive consolidation chemotherapy course HC3 includes dexamethasone (10 mg/m\^2/day IV on Days 1-6), vincrisitne (1.5 mg/m\^2/day IV on Days 1 and 6), daunorubicin (30 mg/m\^2 IV over 24 hours on Day 5), methotrexate (1 g/m\^2 IV over 36 hours on Day 1), ifosfamide (800 mg/m\^2 IV for 1 hour on Days 2-4), and pegylated \[PEG\]-asparaginase (1000 U/m\^2 IV for 2 hours or IM on Day 6) or, if allergic, erwinia-asparaginase (20,000 units/m\^2 IV or IM every 48 hours for a total of 6 doses).
    id
    OG000
    title
    HC3 Chemotherapy
  2. description
    One 4-week cycle of blinatumomab 15 μg/m\^2/day as a continuous intravenous infusion (CIVI).
    id
    OG001
    title
    Blinatumomab
param Type
NUMBER
population Description
Safety Analysis Set: who received protocol-specified therapy analyzed according to the treatment they received.
reporting Status
POSTED
time Frame
From first dose of IP through the last dose of IP (up to Day 29) plus 30 days.
title
Number of Participants With TEAEs of Interest
type
SECONDARY
unit Of Measure
participants

Download exact source JSON → · Snapshot ctgov-results-191f4516d4760045304b24a0

Preserved source evidence · Not medical advice