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在白血病化疗期间,大脑功能和微观结构连接的剂量依赖性损伤
Ashleigh P Scott1,2, Ada Lo3, Ying Xia4
1Department of Haematology and Bone Marrow Transplant, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.
British journal of haematology
|March 13, 2026
概括
针对急性髓性白血病 (AML) 的强化化疗可以改变大脑连接,影响语言网络. 更高的化疗剂量与功能连接性降低相关,这表明对大脑的效果取决于剂量.
科学领域:
- 神经科学是一个神经科学.
- 在瘤学瘤学.
- 放射学 放射学是一门学科.
背景情况:
- 化学脑症状在接受化疗的急性髓性白血病 (AML) 患者中很常见.
- 目前的临床成像缺乏对这些神经变化的实时检测能力.
研究的目的:
- 在AML患者中调查化疗诱导的大脑功能连接和微观结构的变化.
- 探索治疗强度和神经成像发现之间的关系.
主要方法:
- 进行了一项前性,观察性,纵向性队列研究.
- 在密集化疗期间,20名新诊断为AML的成年人接受了连续的神经认知评估和功能性MRI (fMRI).
- 白质纤维密度是使用扩散张力成像来评估的.
主要成果:
- fMRI显示,化疗后,突出部分 (前带皮层) 和左侧语言网络 (下额头,后上状) 之间的功能连接显著减少.
- 观察到白质纤维密度在体和连接前带状皮质和下额头回形的通道中显著下降.
- 较高的细胞氨基酸剂量与前带皮层-下额头回连接性下降相关.
- 更糟糕的神经影像发现与较低的口语流度得分和治疗强度增加有关 (cytarabine剂量,输血,血清费里丁).
结论:
- 抗AML化疗诱导大脑微观结构和功能连接的可测量变化,特别是影响突出和语言网络.
- 建议,化疗强度 (cytarabine,输血) 对这些大脑变化的作用取决于剂量.
- 这些发现提供了新的证据,将密集化疗与AML患者的特定神经变化联系起来.
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