Central nervous system complications during treatment in childhood acute leukemia

• DOI: 10.1007/s13760-024-02602-0
• Publication Date: 2024-08-27T16:01:56Z
• Authors: Arzu Ekici; Bilgen Ayan; Elif Güler Kazancı; Zeynep Beyza Kuşku; Cengiz Gökhan Orcan; Cengiz Havalı; Sevil Dorum; Taha Metin; Betül Biner Orhaner
• Keywords: Acute lymphocytic leukemia; Hemiparesis

Abstract Objective Central nervous system (CNS) complications can be seen in patients with leukemia, depending on the disease itself and the chemotherapeutic agents used. This study focused on CNS complications during treatment in children with acute leukemia in a single pediatric institution Methods We retrospectively analyzed the clinical reports of 115 children with acute leukemia. Results A total of 115 children’ clinical records with acute leukemia over a four-year period, were reviewed. Acute CNS complications developed in 23.1% of AML patients and in 13.5% of ALL patients. CNS complication developed most frequently during the induction phase of the treatment (66.7%). Seizures were the most common symptom (9 patients, 50%), followed by hemiparesis (4 patients, 22.2%) and headache (4 patients, 22.2%). Six patients (33.3%) had chemotherapy-induced toxic leukoencephalopathy, two (11.1%) had Wernicke's encephalopathy, and one patient (5.6%) each had sinus vein thrombosis, posterior reversible encephalopathy syndrome, and CNS infection. Sequelae occurred in three patients (16.7%) and only one patient (5.6%) died due to a CNS complication. Conclusion CNS complications in children with leukemia may present with a wide variety of symptoms. Despite the long-term use of chemotherapeutic agents, their side effects are still not fully clarified. Systemic evaluation of the patients and a multidisciplinary approach are important.