2022-05-272022-05-272015-10Baytan, B. vd. (2015). "Acute central nervous system complications in pediatric acute lymphoblastic leukemia". Pediatric Neurology, 53(4), 312-318.https://doi.org/10.1016/j.pediatrneurol.2015.03.006https://www.sciencedirect.com/science/article/pii/S0887899415001459http://hdl.handle.net/11452/26743BACKGROUND: The outcome of childhood acute lymphoblastic leukemia has improved because of intensive chemotherapy and supportive care. The frequency of adverse events has also increased, but the data related to acute central nervous system complications during acute lymphoblastic leukemia treatment are sparse. The purpose of this study is to evaluate these complications and to determine their long term outcome. PATIENTS AND METHODS: We retrospectively analyzed the hospital reports of 323 children with de novo acute lymphoblastic leukemia from a 13-year period for acute neurological complications. The central nervous system complications of leukemic involvement, peripheral neuropathy, and post-treatment late-onset encephalopathy, and neurocognitive defects were excluded. RESULTS: Twenty-three of 323 children (7.1%) suffered from central nervous system complications during acute lymphoblastic leukemia treatment. The majority of these complications (n = 13/23; 56.5%) developed during the induction period. The complications included posterior reversible encephalopathy (n = 6), fungal abscess (n = 5), cerebrovascular lesions (n = 5), syndrome of inappropriate secretion of antidiuretic hormone (n = 4), and methotrexate encephalopathy (n = 3). Three of these 23 children (13%) died of central nervous system complications, one from an intracranial fungal abscess and the others from intracranial thrombosis. Seven of the survivors (n = 7/20; 35%) became epileptic and three of them had also developed mental and motor retardation. CONCLUSIONS: Acute central neurological complications are varied and require an urgent approach for proper diagnosis and treatment. Collaboration among the hematologist, radiologist, neurologist, microbiologist, and neurosurgeon is essential to prevent fatal outcome and serious morbidity.eninfo:eu-repo/semantics/closedAccessAbscessAcute central nervous system complicationsAcute lymphoblastic leukemiaALL-BFM protocolsCerebrovascular complicationsChildrenPosterior leukoencephalopathy syndromeInvasive aspergillosisNeurologic complicationsAcute neurotoxicityIschemic-strokeL-asparaginaseChildrenMethotrexateTherapyNeurosciences & neurologyPediatricsAzidesBrainCentral nervous system diseasesChildChild, preschoolFemaleHumansMagnetic resonance imagingMaleOctreotidePrecursor cell lymphoblastic leukemia-lymphomaRetrospective studiesArticle0003620565000062-s2.0-8494181107131231853426202590Clinical neurologyPediatricsMethotrexate; Cytarabine; Precursor Cell Lymphoblastic Leukemia-LymphomaAnticonvulsive agentAntifungal agentAntihypertensive agentAsparaginaseCyclophosphamideCytarabineDaunorubicinDexamethasoneDoxorubicinEtoposideHeparinIfosfamideMercaptopurineMethotrexatePrednisoloneVasopressinVincristineAzideEE 581OctreotideAcute lymphoblastic leukemiaAdolescentAdverse outcomeAphasiaArticleBlindnessBrain abscessBrain diseaseBrain hemorrhageCancer combination chemotherapyCancer palliative therapyCancer survivorCancer therapyCentral nervous system aspergillosisChildChildhood leukemiaClinical evaluationControlled studyConvulsionDrug induced headacheDrug megadoseEEG abnormalityEpilepsyFacial nerve paralysisFatalityFemaleFocal epilepsyHormone releaseHumanInduction chemotherapyLong term careMajor clinical studyMaleMedical informationMental deficiencyMotor retardationNeurological complicationOcclusive cerebrovascular diseaseOutcome assessmentPosterior reversible encephalopathy syndromePriority journalRetrospective studySchool childTransient ischemic attackVisual impairmentAnalogs and derivativesBrainCentral nervous system diseasesComplicationNuclear magnetic resonance imagingPathologyPathophysiologyPrecursor cell lymphoblastic leukemia-lymphomaPreschool child