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Changes in the EEG background activity of children with acute lymphoblastic leukemia during cytotoxic therapy
U Lichter-Konecki1, C Benninger, W E Brandeis
1University Children's Hospital, University of Heidelberg, F.R.G.
Insights
This study found that certain chemotherapy drugs, specifically vincristine and L-asparaginase, caused significant slowing in the EEG background activity of children with acute lymphoblastic leukemia (ALL). This EEG alteration correlated with drug administration during treatment.
Area of Science:
- Pediatric Oncology
- Neuroscience
- Pharmacology
Background:
- Acute lymphoblastic leukemia (ALL) is a common childhood cancer.
- Cytotoxic therapy is the standard treatment for ALL.
- Potential central nervous system (CNS) side effects of chemotherapy require investigation.
Purpose of the Study:
- To investigate the electroencephalogram (EEG) changes in children with ALL during cytotoxic therapy.
- To correlate EEG findings with the clinical course and specific drug regimens.
- To identify the chemotherapeutic agents responsible for observed CNS alterations.
Main Methods:
- EEG recordings were performed on 13 children with ALL before and during chemotherapy.
- EEG background activity was analyzed for frequency changes.
- Findings were compared to a control group of 295 healthy children.
- EEG data were correlated with the administered therapy protocol.
Main Results:
- A significant slowing of EEG background activity was observed prior to therapy.
- Further slowing occurred with the administration of combination chemotherapy including vincristine (VCR), daunorubicin (DAU), adriblastine (ADR), prednisone (PRED), and L-asparaginase (L-ASP).
- The observed EEG slowing correlated specifically with the administration of these drugs.
Conclusions:
- Vincristine (VCR) and L-asparaginase (L-ASP) are the likely causative agents for the observed central nervous system alterations (EEG slowing) in children undergoing ALL treatment.
- Daunorubicin (DAU), adriblastine (ADR), and prednisone (PRED) do not appear to significantly influence EEG activity in this context.
- These findings highlight the importance of monitoring neurological function during pediatric ALL chemotherapy.
Abstract:
Thirteen children with acute lymphoblastic leukemia (ALL) were investigated before and during cytotoxic therapy. EEG findings were correlated with the clinical course and the therapy protocol and compared with normal data obtained from 295 healthy children. Frequency analysis of the background activity of the EEG revealed an initial slowing of the background activity prior to therapy and further slowing each time a combination of vincristine (VCR), daunorubicin (DAU) or adriblastine (ADR), prednisone (PRED), and L-asparaginase (L-ASP) was administered. The slowing of the background activity correlated only with the administration of these drugs. DAU, ADR, and PRED are not known to influence the EEG; therefore, VCR and L-ASP remain the primary candidates responsible for the central nervous system alteration.