Leukoencephalopathy in children with acute lymphoblastic leukemia after chemotherapy: a retrospective monocenter
Xiao Xiao1, Si-Jia Chu1, Ji-Hong Tang1
1Department of Neurology, Children's Hospital of Soochow University, Suzhou, China.
Insights
Pediatric acute lymphoblastic leukemia (ALL) patients undergoing chemotherapy may develop leukoencephalopathy, presenting with neurological symptoms and characteristic brain lesions. Early detection and treatment are crucial for improving long-term brain development.
Area of Science:
- Pediatric Oncology
- Neuroimaging
- Hematology
Background:
- Investigating leukoencephalopathy in children with acute lymphoblastic leukemia (ALL), particularly post-chemotherapy.
- Understanding the clinical and neuroimaging features of this condition.
Purpose of the Study:
- To characterize the clinical and neuroimaging findings of leukoencephalopathy in pediatric ALL patients.
- To identify risk factors and assess treatment outcomes.
Main Methods:
- Retrospective analysis of clinical data from 17 pediatric ALL patients with leukoencephalopathy and 17 matched controls.
- Review of general information, laboratory results, and neuroimaging findings.
Main Results:
- Neurological symptoms, including seizures, nausea, vomiting, paralysis, and numbness, were prevalent (94.12%).
- Neuroimaging revealed multiple lesions in periventricular areas, parietal lobes, and basal ganglia.
- Significant differences were noted in serum sodium, C-reactive protein, and blood pressure between groups.
Conclusions:
- Chemotherapy is a key risk factor for chemotherapy-induced leukoencephalopathy in pediatric ALL.
- Radiological features are consistent, aiding diagnosis.
- Early intervention improves clinical symptoms and imaging outcomes, supporting long-term brain development.
Background:
To investigate the clinical and neuroimaging characteristics of leukoencephalopathy among children with acute lymphoblastic leukemia (ALL), especially after chemotherapy.
Methods:
Clinical data for 17 pediatric patients with leukoencephalopathy and 17 matched controls were retrospectively analyzed. All participants were children with ALL admitted to the Children's Hospital of Soochow University from May 2011 to April 2021. The data mainly consisted of general information, laboratory studies, and imaging diagnostic results.
Results:
Overall, 94.12% of the patients experienced neurological symptoms. The most common symptoms were seizure (7/17, 41.18%), nausea (5/17, 29.41%), vomiting (5/17, 29.41%), paralysis (5/17, 29.41%), and numbness (4/17, 23.53%). On neuroimaging, multiple and irregular lesions were observed, distributed mainly in the periventricular area (9/17, 52.94%), parietal lobe (6/17, 35.29%), and basal ganglia (5/17, 29.41%). Moreover, there were significant differences in serum sodium (P=0.0001), C-reactive protein (P=0.0124) and blood pressure (P=0.0271) between patients with and without leukoencephalopathy. After aggressive treatment, the clinical symptoms (12/17, 70.59%) and imaging lesions (11/13, 84.62%) gradually improved in most patients.
Conclusions:
Chemotherapy is an important risk factor related to leukoencephalopathy. Although the clinical symptoms of leukoencephalopathy vary widely, there is a high degree of consistency in its radiological features. Abnormal laboratory results may also help the identification of leukoencephalopathy. Early detection and treatment can improve brain development in the long term.
