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The spectrum of acu...
The spectrum of acute central nervous system symptoms during the treatment of childhood acute lymphoblastic leukaemia
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- Banerjee, Joanna (author)
- Helsinki Univ Hosp, Div Pediat Hematol & Oncol & Stem Cell Transplant, Helsinki, Finland.;Univ Helsinki, Helsinki, Finland.
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- Niinimäki, Riitta (author)
- Univ Oulu, Oulu Univ Hosp, Dept Children & Adolescents, Oulu, Finland.;Univ Oulu, PEDEGO Res Unit, Oulu, Finland.
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- Lähteenmäki, Päivi (author)
- Karolinska Institutet
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- Myrberg, Ida Hed (author)
- Karolinska Institutet
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- Arola, Mikko (author)
- Tampere Univ Hosp, Dept Pediat, Tampere, Finland.;Kuopio Univ Hosp, Dept Pediat, Kuopio, Finland.
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- Riikonen, Pekka (author)
- Kuopio Univ Hosp, Dept Pediat, Kuopio, Finland.
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- Lönnqvist, Tuula (author)
- Univ Helsinki, Helsinki, Finland.;Helsinki Univ Hosp, Div Child Neurol, Helsinki, Finland.
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- Palomäki, Maarit (author)
- Helsinki Univ Hosp, Dept Radiol, Helsinki Med Imaging Ctr, Helsinki, Finland.
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- Ranta, Susanna (author)
- Karolinska Institutet
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- Harila-Saari, Arja H. (author)
- Uppsala universitet,Barnneurologi/Barnonkologi
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- Taskinen, Mervi (author)
- Helsinki Univ Hosp, Div Pediat Hematol & Oncol & Stem Cell Transplant, Helsinki, Finland.;Univ Helsinki, Helsinki, Finland.
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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)
- 2019-11
- 2020
- English.
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In: Pediatric Blood & Cancer. - : WILEY. - 1545-5009 .- 1545-5017. ; 67:2
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- 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.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Hematologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Hematology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Pediatrik (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Pediatrics (hsv//eng)
Keyword
- acute lymphoblastic leukaemia
- children
- neurotoxicity
- outcome
- posterior reversible encephalopathy syndrome
- sinovenous thrombosis
- stroke-like syndrome
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Banerjee, Joanna
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Niinimäki, Riitt ...
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Lähteenmäki, Päi ...
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Myrberg, Ida Hed
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Arola, Mikko
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Riikonen, Pekka
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Lönnqvist, Tuula
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Palomäki, Maarit
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Ranta, Susanna
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Harila-Saari, Ar ...
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Taskinen, Mervi
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Hematology
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Pediatrics
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Pediatric Blood ...
- By the university
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Uppsala University
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Karolinska Institutet