Childhood Acute Lymphoblastic Leukemia Showing Unilateral Motor Dysfunction Prior to Chemotherapy: A Diffusion Tensor...

Area of Science:

• Pediatric Neurology
• Neuroimaging
• Hematology Oncology

Background:

• Childhood acute lymphoblastic leukemia (ALL) can present with neurological deficits.
• The underlying cause of pre-chemotherapy motor dysfunction in ALL is not fully understood.
• Corticospinal tract (CST) integrity may be affected in these patients.

Purpose of the Study:

• To evaluate children with lymphoblastic leukemia for corticospinal tract (CST) injury.
• To examine the correlation between CST injury and motor dysfunction before chemotherapy.
• To assess the utility of diffusion tensor tractography (DTT) in pediatric leukemia patients.

Main Methods:

• Diffusion tensor tractography (DTT) was performed on 19 children with leukemia and unilateral motor dysfunction before chemotherapy.
• DTT assessed CST integrity using mean fractional anisotropy (FA) and mean fiber volume (FV).
• Motor function was evaluated by two independent investigators.

Main Results:

• Patients with leukemia showed significantly disrupted CST integrity with decreased FA and FV in the affected CST compared to controls (p < 0.05).
• These DTT findings correlated with the patients' unilateral motor dysfunction.
• Neurological dysfunction and CST injuries were evident prior to chemotherapy.

Conclusions:

• Neurological dysfunction can occur in pediatric acute lymphoblastic leukemia patients before treatment.
• CST injuries, detectable by DTT, correlate with motor deficits in these children.
• DTT is a valuable tool for assessing neural tract status in pediatric leukemia patients with neurological issues.