[Abnormal CT brain scan during acute lymphoblastic leukemia in children]

Area of Science:

• Pediatric Oncology
• Neuroradiology
• Hematology

Background:

• Childhood acute lymphoblastic leukemia (ALL) requires intensive treatment, including central nervous system (CNS) prophylaxis.
• Long-term neuroimaging effects of ALL treatment in children are not fully understood.

Purpose of the Study:

• To evaluate the neuroimaging findings on CT brain scans in children with ALL at various stages of the disease and treatment.
• To assess the prevalence and nature of CT abnormalities in relation to disease status and therapy intensity.

Main Methods:

• Retrospective analysis of CT brain scans in 96 children diagnosed with acute lymphoblastic leukemia.
• Scans were evaluated at diagnosis, after induction chemotherapy, at 9-month follow-up, and several years post-treatment.

Main Results:

• Initial diagnosis scans were mostly normal; post-induction chemotherapy, 55% showed abnormalities (CSF pathway dilatation, white matter hypodensities).
• Follow-up scans revealed persistent, resolved, or aggravated changes. Long-term scans (43%) showed leukodystrophic changes and atrophy.
• Abnormalities were more pronounced in high-risk ALL patients and those receiving intensive CNS prophylaxis.

Conclusions:

• CT brain scan abnormalities are common in children treated for ALL, persisting long-term.
• These changes, including white matter alterations and CSF pathway dilatation, correlate with disease risk and treatment intensity.
• Long-term neuroimaging surveillance is important for children with ALL to monitor treatment-related effects.