Neurotoxic complications of chemotherapy in children with acute lymphoblastic leukemia
O.V. KORYAKINA1, 2, D.S. CHEREPANOVA1
1Ural State Medical University, Yekaterinburg
2Regional Children’s Clinical Hospital, Yekaterinburg
Contact details:
Koryakina O.V. – PhD (medicine), Associate Professor of the Department of Nervous Diseases, Neurosurgery and Medical Genetics
Address: 3 Repina St., Yekaterinburg, Russian Federation, 620028, tel.: +7 (343) 214-86-52, e-mail: koryakina09@mail.ru
Modern therapy of acute lymphoblastic leukemia in children shows high efficiency. However, the outcome of the disease is often determined by the toxicity of chemotherapy drugs. In particular, neurotoxicity, which is characteristic of most anticancer drugs, can lead to severe neurological disorders, which significantly aggravates the course of the underlying disease and determines the formation of disability. The article presents two clinical cases that demonstrate severe chemoinduced neurological disorders in children. In the first case, damage to the central nervous system due to intraventricular administration of methotrexate is described. The second case demonstrates a severe degree of chemoinduced polyneuropathy with vincristine. Both children received the status of a patient in need of palliative care because of the complications received. The presence of such cases in practice dictates the need to develop new diagnostic methods aimed at early detection of neurotoxic complications, as well as to identify groups with high risk of the formation of chemoinduced neurological disorders.
Key words: acute lymphoblastic leukemia, neurotoxic complications, chemo-induced polyneuropathy, leukoencephalopathy.
REFERENCES
- Siegel R.L., Miller K.D., Wagle N.S., Jemal A. Cancer statistics. 2023. CA: a cancer journal for clinicians, 2023, vol. 73, pp. 17–48. DOI: 10.3322/caac.21763
- Zlokachestvennye novoobrazovaniya v Rossii v 2020 g. (zabolevaemost’ i smertnost’), pod red. A.D. Kaprina i dr. [Malignant neoplasms in Russia in 2020 (morbidity and mortality), ed. Kaprin A.D. et al.]. Moscow: MNIOI im. P.A. Gertsena — filial FGBU “NMITs radiologii”, MZ RF, 2021. 252 p.
- Śliwa-Tytko P., Kaczmarska A., Lejman M., Zawitkowska J. Neurotoxicity Associated with Treatment of Acute Lymphoblastic Leukemia Chemotherapy and Immunotherapy. International Journal of Molecular Sciences, 2022, vol. 23 (10). DOI: 10.3390/ijms23105515
- Inaba H., Mullighan C. Pediatric acute lymphoblastic leukemia. Haematologica, 2020, vol. 105 (11), pp. 2524–2539. DOI: 10.3324/haematol.2020.247031
- Natrusova N.V., Shchederkina I.O., Seliverstova E.V. et al. Leukopathy with a stroke-like course in children with acute lymphoblastic leukemia. Rossiyskiy zhurnal detskoy gematologii i onkologii, 2021, no. 1 (8), pp. 14–22 (in Russ.).
- Evsyutina E.P., Dinikina Yu.V., Belogurova M.B., Aleksandrovich Yu.S. Prevention of toxicity during chemotherapy with high doses of methotrexate in children. Pediatr, 2019, no. 10 (2), pp. 89–98 (in Russ.).
- Dinikina Yu.V., Smirnova A.Yu., Golubeva K.M. et al. The use of high doses of methotrexate in children with oncological diseases: features of accompanying therapy, toxicity assessment. Rossiyskiy zhurnal detskoy gematologii i onkologii, 2018, no. 2 (5), pp. 11–18 (in Russ.).
- Bjornard K.L., Gilchrist L.S. Peripheral neuropathy in children and adolescents treated for cancer. Lancet Child Adolesc Health, 2018, vol. 2 (10), pp. 744–754.
- Sharipova M.G., Smirnov D.S., Yakupov M.R., Spichak I.I. Chemoinduced polyneuropathy in children with oncological pathology. Pediatricheskiy vestnik Yuzhnogo Urala, 2016, no. 1, pp. 53–61 (in Russ.).
- Van de Velde M.E., Kaspersa G.L., Abbinka F.C.H. et al. Vincristine-induced peripheral neuropathy in children with cancer: A systematic review. Critical Reviews in Oncology / Hematology, 2017, vol. 114, rr. 114–130.