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Updated: Mar 24, 2026
Murine Model of Leukemia Relapse to Induction Chemotherapy for Acute Lymphoblastic Leukemia
Published on: October 17, 2025
[Brain injury after induction chemotherapy in children with acute lymphoblastic leukemia]
Dong-Fang Zou1, Hong-Wu Zeng, Jie Yu
1Department of Neurology, Shenzhen Children's Hospital of Chongqing Medical University, Shenzhen, Guangdong 518038, China. fwen62@126.com.
Insights
Cranial MRI reveals that children with acute lymphoblastic leukemia (ALL) often have skull bone marrow infiltration and brain changes before chemotherapy. Some brain injuries in ALL patients may improve after treatment.
Area of Science:
- Pediatric Oncology
- Neuroradiology
- Hematology
Context:
- Acute lymphoblastic leukemia (ALL) is a common childhood cancer.
- Chemotherapy, particularly cranial irradiation, can lead to neurotoxicity.
- Understanding treatment-related brain changes is crucial for managing ALL patients.
Purpose:
- To evaluate cranial MRI findings in children with ALL before and after induction chemotherapy.
- To identify specific brain injuries associated with ALL and its treatment.
Summary:
- Retrospective analysis of 62 children with ALL showed skull bone marrow infiltration in 53% before chemotherapy.
- Brain atrophy (7%) and sensory conduction bundle abnormalities (3%) were observed pre-treatment.
- Post-chemotherapy MRI in 28 patients revealed new or aggravated brain atrophy in 11%.
Impact:
- Findings highlight the prevalence of pre-existing brain abnormalities in pediatric ALL.
- This study provides insights into the neurotoxic effects of chemotherapy in ALL.
- Results emphasize the need for careful monitoring of neurological complications in ALL survivors.
Objective:
To investigate the changes in brain injury after the induction chemotherapy in children with acute lymphoblastic leukemia (ALL) by cranial MRI.
Methods:
The clinical data and cranial MRI results of 62 children with ALL who were hospitalized from March 2014 to June 2015 were analyzed retrospectively.
Results:
Before chemotherapy, MRI showed bone marrow infiltration of the skull in 33 patients (53%); the children with WBC<20×10(9)/Lhad a significantly lower incidence rate of bone marrow infiltration of the skull than those with WBC≥20×10(9)/L (16 patients/42% vs 17 patients/71%; P<0.05), and the high-risk group had a significantly higher incidence rate of bone marrow infiltration of the skull than the non-high-risk group (71% vs 44%; P<0.05). Before chemotherapy, there were 4 cases (7%) of brain atrophy, and 2 cases (3%) of abnormal signals in the sensory conduction bundle. MRI reexamination in 28 patients after 3 months of chemotherapy showed 3 new cases (11%) of brain atrophy and 1 aggravated case of brain atrophy.
Conclusions:
The children with ALL have bone marrow infiltration of the skull, brain atrophy, and abnormal signals in the sensory conduction bundle before chemotherapy, especially bone marrow infiltration of the skull, and some changes in brain injury disappear after treatment.
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