Pattern and Outcome of Neurological Complications During the Treatment of Pediatric Acute Leukemias in Upper Egypt
Sayed, H., Hussein, R., Atta, H., Abdelhamed, M., Shibl, A. (2022). Pattern and Outcome of Neurological Complications During the Treatment of Pediatric Acute Leukemias in Upper Egypt. EKB Journal Management System, 18(1), 29-36. doi: 10.21608/resoncol.2021.77935.1145
Heba Sayed; Radwa Hussein; Haisam Atta; Mohamed A. Abdelhamed; Azza Shibl. "Pattern and Outcome of Neurological Complications During the Treatment of Pediatric Acute Leukemias in Upper Egypt". EKB Journal Management System, 18, 1, 2022, 29-36. doi: 10.21608/resoncol.2021.77935.1145
Sayed, H., Hussein, R., Atta, H., Abdelhamed, M., Shibl, A. (2022). 'Pattern and Outcome of Neurological Complications During the Treatment of Pediatric Acute Leukemias in Upper Egypt', EKB Journal Management System, 18(1), pp. 29-36. doi: 10.21608/resoncol.2021.77935.1145
Sayed, H., Hussein, R., Atta, H., Abdelhamed, M., Shibl, A. Pattern and Outcome of Neurological Complications During the Treatment of Pediatric Acute Leukemias in Upper Egypt. EKB Journal Management System, 2022; 18(1): 29-36. doi: 10.21608/resoncol.2021.77935.1145

Pattern and Outcome of Neurological Complications During the Treatment of Pediatric Acute Leukemias in Upper Egypt

Research in Oncology
Article 4, Volume 18, Issue 1, June 2022, Page 29-36  XML PDF (185.51 K)
Document Type: Original Article
DOI: 10.21608/resoncol.2021.77935.1145
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Authors
Heba Sayed1; Radwa Hussein1; Haisam Atta2; Mohamed A. Abdelhamed3; Azza Shibl email orcid 1
1Pediatric Oncology and Hematological Malignancies Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
2Radiology Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
3Neurology and Psychiatry Department, Faculty of Medicine, Assiut University, Assiut, Egypt
Abstract
Background: Despite the treatment progress of acute leukemias, neurological complications (NCs) can occur and may have a detrimental impact on the outcome.
Aim: To study the pattern and outcome of NCs occurring during treatment of pediatric acute leukemias in Upper Egypt and to study possible factors influencing their outcomes.
Methods: Children with AL who developed NCs during treatment were included. Patients with central nervous system (CNS) infiltration at diagnosis and those with any neurological insults before diagnosis were excluded. Data were retrospectively collected from patient files and included NCs, their outcome, and possible associated factors.
Results: Neurological complications occurred in 89 out of 537 (16.6%) reviewed patients. Age was ≥ 10 years in 47.2% of patients, acute lymphoblastic leukemia was the most common diagnosis (77.5%) and the majority (77.9%) were classified as high-risk. Almost half of the patients suffered from NCs during the induction phase of treatment. Motor deficits and seizures were the most frequent manifestations. Neurovascular causes and peripheral neuropathy constituted 27% and 21.3% of the etiology. Other causes included CNS relapse (19.1%), seizures due to systemic causes (13.5%), CNS infections (12.4%), and leukoencephalopathy (6.7%). The treatment phase and recovery time differed significantly according to the type of NCs. The outcome of NCs was complete recovery in 67.4% of the patients, incomplete recovery in 7.9%, and no recovery and death in 24.7%. The etiology of NCs was the only factor that had a significant correlation with the outcome of the patients.
Conclusions: Neurological complications during treatment occur in a significant proportion of pediatric patients with acute leukemia in South Egypt. Neurovascular causes and peripheral neuropathy are the most common NCs, and CNS hemorrhage is the most fatal. Supportive measures for these NCs must be optimized to improve outcome.
Keywords
Acute leukemia; Neurological complications; Pediatric; Treatment; Upper Egypt
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