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Brainstem auditory pathway of children with acute lymphoid leukemia on chemotherapy with methotrexate

Renata Aparecida Leite1, Jéssica Sales Vosgrau1, Leticia Cortez Neto1

  • 1Universidade de São Paulo, Faculdade de Medicina, Curso de Fonoaudiologia, São Paulo SP, Brazil.

Arquivos De Neuro-Psiquiatria
|February 6, 2020
PubMed

Insights

Children undergoing chemotherapy for acute lymphoblastic leukemia (ALL) may experience auditory pathway damage in the brainstem. This hearing impairment, particularly in the lower brainstem, is linked to methotrexate treatment.

Area of Science:

  • Neuroscience
  • Pediatric Oncology
  • Audiology

Background:

  • Acute lymphoblastic leukemia (ALL) is a common childhood cancer.
  • Chemotherapy, including methotrexate, is a standard treatment for ALL.
  • Chemotherapy can have ototoxic side effects, potentially affecting hearing.

Purpose of the Study:

  • To investigate auditory pathway function in the brainstem of children with ALL receiving chemotherapy.
  • To identify potential correlations between chemotherapy regimens and auditory pathway alterations.

Main Methods:

  • Evaluation of 14 children (ages 2-12) diagnosed with ALL.
  • Utilized audiological assessments including acoustic immitance, audiometry, otoacoustic emissions, and auditory brainstem response (ABR).

Main Results:

  • 35.71% of children with normal hearing thresholds exhibited ABR alterations.
  • Auditory impairment showed a predominance in the lower brainstem.
  • 80% of affected children received intrathecal methotrexate within 30 days; 40% had high cumulative intravenous methotrexate doses.

Conclusions:

  • Chemotherapy for ALL can lead to brainstem auditory pathway impairment in children.
  • The lower brainstem appears particularly vulnerable.
  • Intrathecal and cumulative intravenous methotrexate doses may be associated with these auditory changes.
Abstract

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