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Sökning: onr:"swepub:oai:DiVA.org:uu-438344" > The spectrum of acu...

  • Banerjee, JoannaHelsinki Univ Hosp, Div Pediat Hematol & Oncol & Stem Cell Transplant, Helsinki, Finland.;Univ Helsinki, Helsinki, Finland. (författare)

The spectrum of acute central nervous system symptoms during the treatment of childhood acute lymphoblastic leukaemia

  • Artikel/kapitelEngelska2020

Förlag, utgivningsår, omfång ...

  • 2019-11
  • WILEY,2020
  • printrdacarrier

Nummerbeteckningar

  • LIBRIS-ID:oai:DiVA.org:uu-438344
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-438344URI
  • https://doi.org/10.1002/pbc.27999DOI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:142212098URI

Kompletterande språkuppgifter

  • Språk:engelska
  • Sammanfattning på:engelska

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Klassifikation

  • Ämneskategori:ref swepub-contenttype
  • Ämneskategori:art swepub-publicationtype

Anmärkningar

  • Background: Children with central nervous system (CNS) toxicity during therapy for acute lymphoblastic leukaemia (ALL) are at risk for treatment modifications, long-term sequelae and even higher mortality. A better understanding of CNS symptoms and their complications improves the potential to prevent and treat them.Methods: Patient files from 649 children treated with Nordic Society of Pediatric Hematology and Oncology ALL92 and ALL2000 protocols in Finland were reviewed retrospectively for any acute CNS symptom. Detailed data on symptoms, examinations and treatment of the underlying CNS complications were collected from the medical records. Disease-related and outcome data were retrieved from the Nordic leukaemia registry.Results: Altogether, 13% (86) of patients with ALL had acute CNS symptoms. Most symptoms (64%) occurred during the first 2 months of therapy. Posterior reversible encephalopathy syndrome was the most frequent complication (4.5%). Cerebrovascular events were diagnosed in 10 cases (1.6%), while methotrexate-related stroke-like syndrome (SLS) was observed in only one patient (0.2%). CNS symptoms due to systemic or unclear conditions, especially sepsis, were important for differential diagnosis. CNS leukaemia was associated with CNS symptoms (hazard ratio [HR] = 4.03; P = .003), and epilepsy was a common sequel of CNS complications (19%).Conclusions: Acute CNS symptoms are common during ALL therapy, occurring mainly during the first 2 months of treatment. Patients with CNS leukaemia at diagnosis are at a higher risk for CNS toxicity. Despite intensive CNS-directed methotrexate treatment, SLS was diagnosed extremely rarely in our series.

Ämnesord och genrebeteckningar

Biuppslag (personer, institutioner, konferenser, titlar ...)

  • Niinimäki, RiittaUniv Oulu, Oulu Univ Hosp, Dept Children & Adolescents, Oulu, Finland.;Univ Oulu, PEDEGO Res Unit, Oulu, Finland. (författare)
  • Lähteenmäki, PäiviKarolinska Institutet (författare)
  • Myrberg, Ida HedKarolinska Institutet (författare)
  • Arola, MikkoTampere Univ Hosp, Dept Pediat, Tampere, Finland.;Kuopio Univ Hosp, Dept Pediat, Kuopio, Finland. (författare)
  • Riikonen, PekkaKuopio Univ Hosp, Dept Pediat, Kuopio, Finland. (författare)
  • Lönnqvist, TuulaUniv Helsinki, Helsinki, Finland.;Helsinki Univ Hosp, Div Child Neurol, Helsinki, Finland. (författare)
  • Palomäki, MaaritHelsinki Univ Hosp, Dept Radiol, Helsinki Med Imaging Ctr, Helsinki, Finland. (författare)
  • Ranta, SusannaKarolinska Institutet (författare)
  • Harila-Saari, Arja H.Uppsala universitet,Barnneurologi/Barnonkologi(Swepub:uu)arjha456 (författare)
  • Taskinen, MerviHelsinki Univ Hosp, Div Pediat Hematol & Oncol & Stem Cell Transplant, Helsinki, Finland.;Univ Helsinki, Helsinki, Finland. (författare)
  • Helsinki Univ Hosp, Div Pediat Hematol & Oncol & Stem Cell Transplant, Helsinki, Finland.;Univ Helsinki, Helsinki, Finland.Univ Oulu, Oulu Univ Hosp, Dept Children & Adolescents, Oulu, Finland.;Univ Oulu, PEDEGO Res Unit, Oulu, Finland. (creator_code:org_t)

Sammanhörande titlar

  • Ingår i:Pediatric Blood & Cancer: WILEY67:21545-50091545-5017

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