دورية أكاديمية

Acute neurological complications during acute lymphoblastic leukemia therapy: A single-center experience over 10 years.

التفاصيل البيبلوغرافية
العنوان: Acute neurological complications during acute lymphoblastic leukemia therapy: A single-center experience over 10 years.
المؤلفون: Rahiman EA; Pediatric Hematology Oncology unit, Department of Pediatrics, Advanced Pediatric Center, Chandigarh, India., Rajendran A; Pediatric Hematology Oncology unit, Department of Pediatrics, Advanced Pediatric Center, Chandigarh, India., Sankhyan N; Pediatric Neurology unit, Department of Pediatrics, Advanced Pediatric Center, Chandigarh, India., Singh P; Department of Radio-diagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, India., Muralidharan J; Pediatric Critical Care unit, Department of Pediatrics, Advanced Pediatric Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India., Bansal D; Pediatric Hematology Oncology unit, Department of Pediatrics, Advanced Pediatric Center, Chandigarh, India., Trehan A; Pediatric Hematology Oncology unit, Department of Pediatrics, Advanced Pediatric Center, Chandigarh, India.
المصدر: Indian journal of cancer [Indian J Cancer] 2021 Oct-Dec; Vol. 58 (4), pp. 545-552.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Medknow Publications Country of Publication: India NLM ID: 0112040 Publication Model: Print Cited Medium: Internet ISSN: 1998-4774 (Electronic) Linking ISSN: 0019509X NLM ISO Abbreviation: Indian J Cancer Subsets: MEDLINE
أسماء مطبوعة: Publication: Mumbai : Medknow Publications
Original Publication: Bombay, Indian Cancer Society.
مواضيع طبية MeSH: Nervous System Diseases/*etiology , Precursor Cell Lymphoblastic Leukemia-Lymphoma/*complications, Female ; Humans ; Male ; Nervous System Diseases/pathology ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/pathology ; Retrospective Studies ; Risk Factors ; Time Factors
مستخلص: Background: Acute neurological complications occur in 3.6-11% of children treated for acute lymphoblastic leukemia (ALL). This analysis aimed to evaluate the profile of acute neuro-toxicity and its etiology in children with ALL.
Methods: A retrospective case analysis of central nervous system events in children treated for ALL at our center was performed. Details of events were retrieved from the case records (January 2006-December 2015) and analyzed.
Results: Ninety (9.5%) neurological events occurred in 923 patients treated for ALL. Phase of therapy were: induction (38), consolidation (5), interim maintenance (5), intensification (15) and maintenance (27). Seizures and neurological deficits were the presenting features in 64 and 40 children, respectively. Events included : neuro-infections in 18, posterior reversible encephalopathy syndrome (PRES) in 7, epilepsy in 6, intracranial bleed in 5, systemic infection with neurological complication in 4, hydrocephalus and aseptic meningitis in 3 each, methotrexate encephalopathy and metabolic seizures in 2 children each. Seizures and status epilepticus of unknown etiology and neurological deficits of unknown etiology was observed in 26 and 13 children, respectively. Seizures occurred mainly in induction (12) and intensification phase (9). Status epilepticus transpired in maintenance phase in 9/14 patients. Induction phase was complicated by PRES in 7, intracranial bleed in 5 and cerebral sinus venous thrombosis in 1 patient. Neuroimaging was done in 86% of events. There were 18 (20.6%) deaths: neuro-infections (8), status epilepticus (6), systemic infection (2), bleed (1), and unexplained encephalopathy (demyelination)(1). At last follow-up, 53 patients were well and 7 children persist to have a neurological disability.
Conclusion: Ten percent of children on treatment for ALL suffered an acute neuro-toxicity. Morbidity and high-incidence of neuroinfections are major concerns.
Competing Interests: None
فهرسة مساهمة: Keywords: Acute leukemia; encephalopathy; neurotoxicity; seizures; status epilepticus
تواريخ الأحداث: Date Created: 20210812 Date Completed: 20220214 Latest Revision: 20220429
رمز التحديث: 20221213
DOI: 10.4103/ijc.IJC_422_19
PMID: 34380827
قاعدة البيانات: MEDLINE
الوصف
تدمد:1998-4774
DOI:10.4103/ijc.IJC_422_19