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Acute encephalopathy during induction therapy for acute lymphoblastic leukemia
M P Gerrard1, O B Eden, J S Lilleyman
1Department of Haematology, Royal Hospital for Sick Children, Edinburgh, Scotland.
Pediatric Hematology and Oncology
|January 1, 1986
Summary
Acute encephalopathy in children undergoing chemotherapy for acute lymphoblastic leukemia (ALL) may be linked to drug toxicity. Some patients died, but survivors appear neurologically normal.
Area of Science:
- Pediatric Oncology
- Neurotoxicity
- Hematology
Background:
- Induction chemotherapy for acute lymphoblastic leukemia (ALL) can cause severe side effects.
- Encephalopathic illness, characterized by convulsions and coma, is a significant concern in pediatric cancer patients.
Purpose of the Study:
- To describe the clinical features and outcomes of acute encephalopathy in children receiving chemotherapy for ALL.
- To investigate the potential link between drug toxicity and encephalopathic events during ALL induction therapy.
Main Methods:
- Retrospective case series describing 21 children with acute encephalopathy during ALL induction chemotherapy.
- Clinical data analysis focusing on presenting symptoms, potential causes, and patient outcomes.
Main Results:
- Twenty-one children experienced acute encephalopathy, with convulsions and coma as major symptoms.
- In the absence of other causes, the encephalopathy was attributed to drug toxicity.
- Two children died during the initial illness, and 4 of the survivors later died.
- Modifications to antileukemic therapy may have influenced outcomes for some patients.
Conclusions:
- Drug toxicity is a likely cause of acute encephalopathy in children undergoing ALL induction chemotherapy.
- While some patients experienced fatal outcomes, surviving children appear to have normal neurological and developmental status.
- Careful monitoring and potential therapeutic modifications are crucial for managing chemotherapy-induced neurotoxicity in pediatric ALL.