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Published on: October 17, 2025
Cerebrovascular complications in pediatric patients with acute lymphoblastic leukemia
Agata Rocka1, Maria Lesniak2, Patrycja Majka2
1Department of Pediatric Radiology, Medical University of Lublin, Al. Racławickie 1, 20-059, Lublin, Poland. agatarocka2@gmail.com.
Insights
Cerebrovascular complications, including seizures and ischemic events, affect over 12% of children with acute lymphoblastic leukemia (ALL), primarily during induction therapy. Early detection using MRI is crucial for managing these central nervous system (CNS) issues.
Area of Science:
- Pediatric Oncology
- Neurology
- Hematology
Background:
- Acute lymphoblastic leukemia (ALL) is the most common pediatric cancer.
- Central nervous system (CNS) complications occur in about 10% of pediatric ALL cases.
Purpose of the Study:
- To analyze the incidence and characteristics of cerebrovascular complications in pediatric ALL patients.
- To identify key symptoms and diagnostic findings associated with CNS complications in this cohort.
Main Methods:
- Retrospective analysis of 144 pediatric ALL patients treated between 2014 and 2023.
- Statistical analysis using PQStat software.
- Review of patient data including demographics, treatment phase, symptoms, and diagnostic imaging (MRI).
Main Results:
- 12.5% of pediatric ALL patients developed cerebrovascular complications.
- Complications were most frequent during induction therapy (83.3%).
- Seizures (50%) and impaired consciousness (39%) were the most common symptoms; MRI revealed ischemic events in 44.4% of affected patients.
Conclusions:
- CNS complications are a significant concern in pediatric ALL, particularly during induction therapy.
- Seizures and ischemic events are common manifestations requiring prompt diagnosis.
- MRI is vital for early detection, and further research is needed to minimize neurotoxicity.
Abstract:
Acute lymphoblastic leukemia (ALL) is the most common childhood cancer, with central nervous system (CNS) complications occurring in approximately 10% of cases. This study aimed to analyze cerebrovascular complications in pediatric ALL patients. We conducted a retrospective analysis of 144 pediatric ALL patients treated at the University Children's Hospital in Lublin from 2014 to 2023. Statistical analyses were performed using PQStat software. Among the patients, 12.5% (n = 18) developed cerebrovascular complications, with equal distribution between genders. The median age was 6.3 years. Most complications (83.3%) occurred during induction therapy. The most frequent symptom was seizures (50%), followed by impaired consciousness (39%). Magnetic resonance imaging (MRI) detected ischemic complications in 44.4% of affected patients. No significant correlation was found between risk group, diagnostic parameters, or gender and CNS complications. CNS complications, particularly seizures and ischemic events, are common in pediatric ALL, primarily during induction therapy. MRI plays a crucial role in early detection. Further multicenter studies are necessary to improve management and reduce treatment-related neurotoxicity.
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